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与临床医生采集和自我采集的阴道拭子相比,大冶诊断棉塞检测人乳头瘤病毒的诊断准确性:一项比较研究。

Diagnostic accuracy of the Daye diagnostic tampon compared to clinician-collected and self-collected vaginal swabs for detecting HPV: a comparative study.

作者信息

Milanova Valentina, Gomes Michelle, Mihaylova Kalina, Twelves John Luke, Multmeier Jan, McMahon Hana, McCulloch Hannah, Cuschieri Kate

机构信息

Daye, London, United Kingdom.

Lindus Health, London, United Kingdom.

出版信息

J Clin Microbiol. 2025 May 14;63(5):e0185224. doi: 10.1128/jcm.01852-24. Epub 2025 Apr 11.

DOI:10.1128/jcm.01852-24
PMID:40214249
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12077143/
Abstract

Cervical cancer screening is vital for achieving global elimination of this preventable disease. Vaginal self-sampling (VSS) for human papillomavirus (HPV) has the potential to increase screening uptake, particularly among individuals who may be underserved by clinician collection. Expanding self-sampling options with accurate, acceptable collection devices is essential. The Daye diagnostic tampon (DDT) offers an innovative approach, utilizing a tampon for HPV-based detection. This study assessed the diagnostic accuracy of DDT in detecting high-risk HPV infections, using vaginal clinician-collected swabs (CCS) as the reference standard. In this UK-based study, 260 participants provided CCS and VSS (with Copan FLOQSwabs) and DDT samples for HPV testing. Samples were analyzed using the Aptima HPV assay, which detects 14 high-risk HPV types. The sensitivity, specificity, positive predictive value, and negative predictive value of the DDT were evaluated against the CCS. Invalidity rates-HPV-negative results with negative internal controls-were compared across sampling methods. The DDT showed a sensitivity of 82.9% [95% confidence interval (CI): 72.4%-89.9%], specificity of 91.6% (CI: 86.4%-94.9%), and overall accuracy of 89.0% (CI: 84.4%-92.4%) relative to CCS. McNemar's test showed no significant difference between CCS and DDT results ( = 0.845). Valid result rates were highest for DDT (99.2%), followed by VSS (95.4%) and CCS (90.8%). The DDT demonstrates comparable accuracy to CCS for detecting high-risk HPV. This novel device shows promise as a self-sampling method. Furthermore, complementary research should focus on assessing DDT's clinical performance in detecting HPV associated with cervical disease endpoints.IMPORTANCECervical cancer remains a leading preventable cause of cancer death globally, with persistent disparities in screening access. Self-sampling for HPV has emerged as a critical tool to improve screening uptake, particularly among underserved populations, yet device acceptability and diagnostic reliability remain barriers to equitable implementation. This study demonstrates that the Daye diagnostic tampon (DDT), a novel, tampon-based self-sampling method, achieves diagnostic accuracy comparable to clinician-collected swabs (sensitivity 82.9% and specificity 91.6%) while yielding fewer invalid results (0.8%) than conventional swabs. By aligning with a familiar menstrual product, the DDT addresses usability concerns that hinder confidence in existing self-sampling devices, as evidenced by 70.5% participant preference in focus groups. These findings advance progress toward World Health Organisation (WHO) cervical cancer elimination targets by validating a culturally resonant, high-performance alternative to clinic-based sampling. The DDT's potential to expand screening access, especially in low-resource settings or among individuals avoiding pelvic exams, could transform preventive care landscapes, reducing disparities in a disease rooted in healthcare inequity.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88f5/12077143/2c97b6a97d17/jcm.01852-24.f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88f5/12077143/7167b5035bf1/jcm.01852-24.f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88f5/12077143/438db9b155c5/jcm.01852-24.f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88f5/12077143/2c97b6a97d17/jcm.01852-24.f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88f5/12077143/7167b5035bf1/jcm.01852-24.f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88f5/12077143/438db9b155c5/jcm.01852-24.f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/88f5/12077143/2c97b6a97d17/jcm.01852-24.f003.jpg
摘要

宫颈癌筛查对于在全球范围内消除这种可预防的疾病至关重要。人乳头瘤病毒(HPV)的阴道自我采样(VSS)有可能提高筛查的参与率,特别是在那些可能无法通过临床医生采集样本得到充分服务的人群中。使用准确、可接受的采集设备来扩大自我采样的选择至关重要。大冶诊断棉塞(DDT)提供了一种创新方法,利用棉塞进行基于HPV的检测。本研究以阴道临床医生采集的拭子(CCS)作为参考标准,评估了DDT检测高危HPV感染的诊断准确性。在这项基于英国的研究中,260名参与者提供了CCS、VSS(使用科盼FLOQSwabs)和DDT样本用于HPV检测。样本使用Aptima HPV检测法进行分析,该方法可检测14种高危HPV类型。将DDT的灵敏度、特异性、阳性预测值和阴性预测值与CCS进行了比较。比较了不同采样方法的无效率——内部对照为阴性的HPV阴性结果。相对于CCS,DDT的灵敏度为82.9%[95%置信区间(CI):72.4%-89.9%],特异性为91.6%(CI:86.4%-94.9%),总体准确率为89.0%(CI:84.4%-92.4%)。McNemar检验显示CCS和DDT结果之间无显著差异( = 0.845)。DDT的有效结果率最高(99.2%),其次是VSS(95.4%)和CCS(90.8%)。DDT在检测高危HPV方面显示出与CCS相当的准确性。这种新型设备有望成为一种自我采样方法。此外,补充研究应侧重于评估DDT在检测与宫颈疾病终点相关的HPV方面的临床性能。重要性宫颈癌仍然是全球癌症死亡的主要可预防原因,在筛查可及性方面存在持续的差异。HPV自我采样已成为提高筛查参与率的关键工具,特别是在服务不足的人群中,但设备的可接受性和诊断可靠性仍然是公平实施的障碍。本研究表明,大冶诊断棉塞(DDT)是一种基于棉塞的新型自我采样方法,其诊断准确性与临床医生采集的拭子相当(灵敏度82.9%,特异性91.6%),同时产生的无效结果(0.8%)比传统拭子少。通过与一种熟悉的月经用品相结合,DDT解决了阻碍对现有自我采样设备信心的可用性问题,焦点小组中有70.5%的参与者表示偏好就是证明。这些发现通过验证一种具有文化共鸣、高性能的替代基于诊所采样的方法,推动了朝着世界卫生组织(WHO)消除宫颈癌目标的进展。DDT扩大筛查可及性的潜力,特别是在资源匮乏的环境中或在避免盆腔检查的个体中,可能会改变预防保健格局,减少这种源于医疗保健不平等的疾病中的差异。

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Menstrual Tampons Are Reliable and Acceptable Tools to Self-Collect Vaginal Microbiome Samples.
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