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VALHUDES 框架内自我采集的阴道和尿液标本中 OncoPredict HPV 筛查检测的临床性能。

Clinical Performance of OncoPredict HPV Screening Assay on Self-Collected Vaginal and Urine Specimens Within the VALHUDES Framework.

机构信息

School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.

Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium.

出版信息

J Med Virol. 2024 Nov;96(11):e70079. doi: 10.1002/jmv.70079.

Abstract

The introduction of self-sampling in cervical cancer screening has raised the importance of HPV test validation on self-collected samples. This study aimed to evaluate the clinical accuracy of the OncoPredict HPV Screening (SCR) assay on self-collected vaginal and first-void urine (FVU) samples, relative to cervical specimens, using the VALHUDES Framework. FVU and vaginal self-samples followed by a clinician-collected cervical brushing were collected from 500 women referred to colposcopy and tested using OncoPredict HPV SCR assay. The assay demonstrated clinical sensitivity to detect cervical intraepithelial neoplasia grade 2 or worse (≥ CIN2) similar to cervical samples in FVU (ratio: 0.95, [95% CI: 0.88-1.02]) and vaginal self-samples (ratio: 0.96 [95% CI: 0.90-1.02]). The clinical specificity for < CIN2 was lower in vaginal (ratio: 0.90 [95% CI: 0.84-0.96]) but not in FVU samples (ratio: 1.03 [95% CI: 0.96-1.12) when compared to cervical samples. However, the relative specificity improved following cut-off optimization (ratio: 0.94, 95% CI: [0.88-1.01]). Moderate to excellent agreement in HPV detection between self-collected and cervical samples was demonstrated (Kappa values: 0.53-1.00). To conclude, OncoPredict HPV SCR assay demonstrated similar accuracy on FVU and cervical samples. On vaginal compared to cervical samples sensitivity was similar with a lower specificity, which improved with cut-off optimization.

摘要

自行采样在宫颈癌筛查中的引入提高了 HPV 检测在自行采集样本上验证的重要性。本研究旨在使用 VALHUDES 框架评估 OncoPredict HPV Screening(SCR)检测在自行采集的阴道和首次排空尿液(FVU)样本上相对于宫颈标本的临床准确性。对 500 名转诊行阴道镜检查的女性进行了 FVU 和阴道自行采样,随后由临床医生采集宫颈刷样,并使用 OncoPredict HPV SCR 检测进行检测。该检测在 FVU(比值:0.95 [95%CI:0.88-1.02])和阴道自行样本(比值:0.96 [95%CI:0.90-1.02])中检测到宫颈上皮内瘤变 2 级或更高级别(≥CIN2)的临床敏感性与宫颈样本相似。阴道样本(比值:0.90 [95%CI:0.84-0.96])中< CIN2 的临床特异性低于 FVU 样本(比值:1.03 [95%CI:0.96-1.12]),但与宫颈样本相比,阴道样本(比值:1.03 [95%CI:0.96-1.12])的临床特异性较低。然而,在进行截止值优化后,相对特异性有所提高(比值:0.94,95%CI:[0.88-1.01])。自行采集和宫颈样本中 HPV 检测的一致性为中度至极好(Kappa 值:0.53-1.00)。总之,OncoPredict HPV SCR 检测在 FVU 和宫颈样本上具有相似的准确性。与宫颈样本相比,阴道样本的敏感性相似,但特异性较低,通过截止值优化可以提高特异性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5ba/11590042/a7a377e2fbf9/JMV-96-e70079-g001.jpg

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