Yang Yueming, Xu Lijiang, Yuan Songhua, Lv Jin, Chen Pengchen, Wang Wei
Department of Obstetrics and Gynecology, The First People's Hospital of Foshan, Foshan, 528000, Guangdong, China.
Department of Pathology, The First People's Hospital of Foshan, Foshan, 528000, Guangdong, China.
J Cancer. 2024 May 13;15(11):3612-3624. doi: 10.7150/jca.96128. eCollection 2024.
Cervical cancer is the fourth most common cancer among women worldwide. Cervical cancer usually develops from human papillomavirus (HPV) infection, which leads to cervical intraepithelial neoplasia (CIN1/2/3) and eventually invasive cervical cancer. Therefore, early-screening and detection of cervical lesions are crucial for preventing and treating cervical cancer. However, different regions have different levels of medical resources and availability of diagnostic methods. There is a need to compare the efficiency of different methods and combinations for detecting cervical lesions and provide recommendations for the optimal screening and detection strategies. The current clinical methods for screening and detection of cervical lesions mainly include TruScreen (TS), Thinprep cytologic test (TCT), HPV testing, and colposcopy, but their sensitivity and specificity vary and there is no standard protocol recommended. In this study, we retrospectively reviewed 2286 female samples that underwent cervical biopsy and compared the efficiency of different methods and combinations for detecting cervical lesions. HPV screening showed the highest sensitivity for identifying women with CIN2+ cervical lesions compared with other single methods. Our results also showed the importance and necessary of the secondary diagnostic test like TCT and TS as a triage method before colposcopy examination and guided biopsy. Our study provides recommendations for the optimal screening and detection strategies for cervical lesions in different regions with different levels of development. As a non-invasive, easily operated, and portable device, TS is a promising tool to replace TCT for detecting cervical lesions in the health care center with insufficient medical resources.
宫颈癌是全球女性中第四大常见癌症。宫颈癌通常由人乳头瘤病毒（HPV）感染发展而来，HPV感染会导致宫颈上皮内瘤变（CIN1/2/3），最终发展为浸润性宫颈癌。因此，早期筛查和检测宫颈病变对于预防和治疗宫颈癌至关重要。然而，不同地区的医疗资源水平和诊断方法的可及性各不相同。有必要比较不同方法及其组合检测宫颈病变的效率，并为最佳筛查和检测策略提供建议。目前用于筛查和检测宫颈病变的临床方法主要包括TruScreen（TS）、薄层液基细胞学检测（TCT）、HPV检测和阴道镜检查，但它们的敏感性和特异性各不相同，且没有推荐的标准方案。在本研究中，我们回顾性分析了2286例接受宫颈活检的女性样本，比较了不同方法及其组合检测宫颈病变的效率。与其他单一方法相比，HPV筛查在识别CIN2+宫颈病变女性方面显示出最高的敏感性。我们的结果还显示了TCT和TS等二次诊断测试作为阴道镜检查和引导活检前的分流方法的重要性和必要性。我们的研究为不同发展水平地区的宫颈病变最佳筛查和检测策略提供了建议。作为一种非侵入性、易于操作且便携的设备，TS是一种很有前景的工具，可在医疗资源不足的医疗保健中心替代TCT用于检测宫颈病变。
