Department of Obstetrics and Gynecology, Korea Institute of Radiological & Medical Sciences, Korea Cancer Center Hospital, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Dongnam Institute of Radiological & Medical Sciences, Busan, Republic of Korea.
Int J Gynaecol Obstet. 2021 Jul;154(1):127-132. doi: 10.1002/ijgo.13574. Epub 2021 Jan 27.
To investigate if a self-obtained vaginal sample (SOVAS) contains sufficient DNA for a human papillomavirus (HPV) test and if the results are comparable to those obtained via cervical samples (CS) collected by a physician.
One hundred and fifty-one women who had abnormal cervical smears or who were HPV-positive were enrolled. Self-sampling was done after reading instructions and watching a 2-min-long video, whereas CS was obtained with a cervical cytobrush during a gynecologic examination.
A multiplex real-time polymerase chain reaction-based assay detected the prevalence of any type of HPV to be 67.5% in the SOVAS and 57.4% in the CS, and that of high-risk (HR-) HPV to be 58.7% in the SOVAS and 48.6% in the CS. The sensitivity of detection of HR-HPV in the SOVAS was 100% (95% confidence interval [CI] -0.09 to 0.32) for high-grade squamous intraepithelial lesion, 78% (95% CI -0.09 to 0.13) for atypical squamous cells of undetermined significance or worse, and 95% (95% CI -0.01 to 0.25) for low-grade squamous intraepithelial lesion or worse, which was statistically within the non-inferiority margin compared with that of CS.
Our study shows that the collection of a SOVAS is feasible and it is comparable to a CS for HPV DNA testing. Future studies are required to investigate the feasibility and cost-effectiveness of a mail-delivered SOVAS for cervical cancer screening.
研究自行采集的阴道样本(SOVAS)是否含有足够的 HPV 检测用 DNA,以及其检测结果是否与医生采集的宫颈样本(CS)一致。
本研究共纳入了 151 例宫颈涂片异常或 HPV 阳性的女性。在阅读了说明并观看了时长为 2 分钟的视频后,患者自行采集样本,而 CS 则通过阴道镜检查时使用宫颈刷获取。
采用基于多重实时聚合酶链反应的检测方法,SOVAS 中 HPV 总感染率为 67.5%,CS 中为 57.4%;高危型 HPV(HR-HPV)感染率分别为 58.7%和 48.6%。SOVAS 检测 HR-HPV 的敏感性在高级别鳞状上皮内病变中为 100%(95%置信区间[CI] -0.09 至 0.32),在非典型鳞状细胞不能明确意义或更严重病变中为 78%(95% CI -0.09 至 0.13),在低级别鳞状上皮内病变或更严重病变中为 95%(95% CI -0.01 至 0.25),与 CS 相比均在非劣效性边界内。
本研究表明,采集 SOVAS 是可行的,其 HPV DNA 检测结果与 CS 相当。未来需要研究邮寄自行采集的 SOVAS 进行宫颈癌筛查的可行性和成本效益。