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用于宫颈癌筛查中残留细胞学样本中高危型 HPV 感染检测的 DH3 HPV 检测与 HC2 检测的头对头比较:基线和 3 年纵向数据。

Head-to-Head Comparison of DH3 HPV Test and HC2 Assay for Detection of High-Risk HPV Infection in Residual Cytology Samples from Cervical Cancer Screening Setting: Baseline and 3-Year Longitudinal Data.

机构信息

Centre for Diagnosis & Treatment of Cervical Diseases, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Department of Gynecologic Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Microbiol Spectr. 2022 Feb 23;10(1):e0157021. doi: 10.1128/spectrum.01570-21. Epub 2022 Feb 16.

Abstract

The authors compared the clinical performance of DH3 human papillomavirus (HPV) assay, which detects 14 high-risk HPVs with 16/18 genotyping based on hybrid capture technique, and Hybrid Capture 2 (HC2) test for women undergoing cervical cancer screening. A total of 7, 263 residual cytology specimens from an adjudicated cohort with 3-year follow-up were tested by the DH3 assay and the HC2 test. Assay results were compared with each other and to histology review. The overall agreement between the DH3 assay and the HC2 test was 99.2% (κ = 0.938). At baseline, DH3 had the equal sensitivity to that of HC2 for cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN2+,  = 75) and CIN grade 3 or higher (CIN3+,  = 45), 98.67% and 97.78%, respectively. After 3 years of follow-up, the sensitivity for CIN2+ ( = 133) and CIN3+ ( = 74) were both similar between DH3 and HC2 (95.49% vs 94.74%, 95.95% vs 95.95%, respectively, all  > 0.05). The respective specificity for CIN2+ or CIN3+ did not differ between the two tests. A noninferiority test showed that both sensitivity and specificity of DH3 for CIN2+ and CIN3+ were noninferior to those of HC2 at baseline and after 3-year follow-up, respectively (all  < 0.001). When used in primary screening strategy, the DH3 assay would yield an immediate sensitivity of 92% for CIN2+. DH3 HPV performs equally to HC2 for the detection of high-grade lesions in cervical cancer screening and has a potential advantage in primary screening strategy due to HPV16/18 genotyping. The benefits of testing for high-risk human papillomavirus (hrHPV) in cervical cancer screening have already been demonstrated. Hybrid Capture 2 (HC2) is the best validated HPV assay and has been considered the gold standard for hrHPV testing. However, HC2 cannot discriminate HPV16 and 18 from the other hrHPV types, which greatly limited the application of HC2 in cervical cancer screening. The DH3 human papillomavirus (HPV) is a recently developed assay based on hybrid capture technique like to HC2, which can specifically identify HPV 16/18 on the basis of detecting the 13 hrHPV types targeted by HC2 as well as HPV66. This comparative study of the two assays for detection of hrHPV infection in residual cytology samples from cervical cancer screening setting reveals that DH3 HPV provides a perfect alternative to HC2 in detecting hrHPV infection and identifying cervical precancer, while allowing concurrent HPV 16/18 genotyping.

摘要

作者比较了 DH3 人乳头瘤病毒(HPV)检测(基于杂交捕获技术检测 14 种高危型 HPV,并进行 16/18 型基因分型)与 Hybrid Capture 2(HC2)检测在宫颈癌筛查中对细胞学标本的临床性能。对经过 3 年随访判定的 7263 例剩余细胞学标本进行了 DH3 检测和 HC2 检测。将检测结果与组织学检查结果进行比较。DH3 检测与 HC2 检测的总体一致性为 99.2%(κ=0.938)。在基线时,DH3 检测对宫颈上皮内瘤变(CIN)2 级或更高级别(CIN2+, = 75)和 CIN 3 级或更高级别(CIN3+, = 45)的敏感性与 HC2 检测相当,分别为 98.67%和 97.78%。3 年后随访时,DH3 检测对 CIN2+( = 133)和 CIN3+( = 74)的敏感性与 HC2 检测相似(95.49% vs 94.74%,95.95% vs 95.95%,均  > 0.05)。两种检测方法对 CIN2+或 CIN3+的特异性均无差异。非劣效性检验显示,DH3 检测对 CIN2+和 CIN3+的敏感性和特异性在基线和 3 年后随访时均不劣于 HC2(均  < 0.001)。在初筛策略中,DH3 检测对 CIN2+的即刻敏感性为 92%。DH3 HPV 检测在宫颈癌筛查中对高级别病变的检测与 HC2 相当,并且由于能够进行 HPV16/18 型基因分型,在初筛策略中有潜在优势。检测高危型人乳头瘤病毒(hrHPV)在宫颈癌筛查中的获益已得到证实。Hybrid Capture 2(HC2)是经过充分验证的 HPV 检测方法,被认为是 hrHPV 检测的金标准。然而,HC2 无法区分 HPV16 和 18 与其他 hrHPV 类型,这极大地限制了 HC2 在宫颈癌筛查中的应用。DH3 人乳头瘤病毒(HPV)检测是一种基于杂交捕获技术的新方法,与 HC2 类似,它可以在检测 HC2 所针对的 13 种高危型 HPV 以及 HPV66 的基础上,特异性地识别 HPV16/18。本研究比较了两种检测方法在宫颈癌筛查中剩余细胞学标本中检测 hrHPV 感染的情况,结果表明,DH3 HPV 在检测 hrHPV 感染和识别宫颈癌前病变方面可作为 HC2 的理想替代方法,同时还允许同时进行 HPV16/18 基因分型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f8f/8849094/4a4a9c957164/spectrum.01570-21-f001.jpg

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