- 作者：Annarosa Del Mistro ; Helena Frayle-Salamanca ; Rossana Trevisan ; Mario Matteucci ; Antonella Pinarello ; Pamela Zambenedetti ; Rita Buoso ; Gian Piero Fantin ; Manuel Zorzi ; Daria Minucci
- 关键词：HPV ; Screening ; Triage ; Cervical cancer
- 刊名：Gynecologic Oncology
- 出版年：2010
- 出版时间：April 2010
- 年：2010
- 卷：117
- 期：1
- 页码：77-81
- 全文大小：262 K
ObjectivesTo compare the performance of immediate colposcopy, repeat Pap test and HPV test as triage options for women diagnosed as having atypical squamous cells of undetermined significance (ASC-US) while attending organised screening for cervical carcinoma in five centres of the Veneto region.Methods
Women consecutively diagnosed as having ASC-US were included in a prospective study, and underwent colposcopy and collection of cervico-vaginal cells for conventional Pap test and HPV test (Hybrid Capture 2, High-risk probe set, Digene). Repetition of all three tests was scheduled for 12 months later. DNA was subsequently extracted from residual cells of positive samples, and analysed by polymerase chain reaction with several primers for typing of HPV sequences. Sensitivity, specificity and positive predictive value (PPV) of the different triage options for histology-confirmed cervical intraepithelial neoplasia, grade 2 or worse (CIN2+) were calculated among all women and by age (under and above 35 years).
Results
Seven hundred forty-nine women 25–64 years old (median age 42 years) were enrolled in the study. Pap smears at enrolment were read as ASC-US or more severe in 211 (29.4 % ) cases, colposcopy disclosed an atypical transformation zone in 254 (34.2 % ) women, and HPV test was positive in 181 (24.2 % ). High-grade cervical lesions developed in 29/749 (3.9 % ) women. HPV typing was possible in 163 (90 % ) of the samples, and carcinogenic types were present in 123.
Conclusions
HPV test showed the best performance; overall, it had the highest sensitivity (92.3 % ), specificity (78.6 % ) and PPV (14.9 % ).