基于资源受限环境的子宫颈样本人乳头瘤病毒检测的即时检测技术:研究进展综述。
Point-of-care tests for human papillomavirus detection in uterine cervical samples: A review of advances in resource-constrained settings.
机构信息
Division of Cytopathology, ICMR-National Institute for Cancer Prevention and Research, Noida, Uttar Pradesh, India.
出版信息
Indian J Med Res. 2023 Nov 1;158(5&6):509-521. doi: 10.4103/ijmr.ijmr_1143_23. Epub 2024 Jan 24.
Incidence of cervical cancer and associated mortality are still high in resource-constrained countries due to the lack of infrastructural facilities and trained workforce. Human papillomavirus (HPV)-based screening tests offer a better sensitivity (>90%) for the detection of cervical high-grade lesions. However, these tests usually require an extensive laboratory set-up and trained technical staff. Moreover, the high cost of the currently available and approved HPV tests precludes their use in the cervical cancer screening programmes in resource-limited settings. Hence, there is a felt need for a low-cost point-of-care (POC) HPV test with good performance characteristics to help augment cervical cancer screening in such settings. A recent meta-analysis demonstrated a good sensitivity and specificity for two of the commercially available POC HPV tests. The present review discusses the merits and limitations of the current commercially available POC and near-POC devices for HPV-based cervical cancer screening. The technologies that have the potential to be developed into low-cost POC tests and newer promising modalities for HPV-based POC or near POC have also been highlighted. This review underscores the need for collaborative and coordinated research for development of POC or near-POC HPV-based tests to be used in cervical cancer screening. Efforts need to be focussed on technologies that offer ease of performance without the requirement of sophisticated equipment or extensive sample pre-processing coupled with a good sensitivity and cost-effectiveness.
由于缺乏基础设施和训练有素的劳动力,资源有限的国家的宫颈癌发病率和相关死亡率仍然很高。基于人乳头瘤病毒(HPV)的筛查试验为检测宫颈高级别病变提供了更高的敏感性(>90%)。然而,这些测试通常需要广泛的实验室设置和训练有素的技术人员。此外,目前可用的 HPV 检测的高成本使得它们无法在资源有限的环境中用于宫颈癌筛查计划。因此,人们迫切需要一种具有良好性能特征的低成本即时护理(POC)HPV 检测,以帮助在这些环境中增强宫颈癌筛查。最近的一项荟萃分析表明,两种市售的 POC HPV 检测具有良好的敏感性和特异性。本综述讨论了目前市售的 POC 和近 POC 设备用于 HPV 为基础的宫颈癌筛查的优缺点。本文还强调了具有发展潜力的低成本 POC 测试的新技术,以及用于 HPV 为基础的 POC 或近 POC 的更新颖的方法。这篇综述强调了需要协作和协调研究,以开发用于宫颈癌筛查的 POC 或近 POC 基于 HPV 的测试。需要集中精力开发易于操作的技术,而不需要复杂的设备或广泛的样本预处理,并具有良好的敏感性和成本效益。