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Objective@#To evaluate and compare the screening performance of primary high-risk HPV(HR-HPV) screening and HR-HPV screening plus liquid-based cytology (LBC) cotesting in diagnosis of cervical cancer and precancerous lesions (CIN2+).@*Methods@#We pooled 17 population-based cross-sectional studies which were conducted across China from 1999 to 2008. After obtaining informed consent, all women received liquid-based cytology(LBC)testing, HR-HPV DNA testing. Totally 28 777 women with complete LBC, HPV and biopsy results were included in the final analysis. Screening performance of primary HR-HPV DNA screening and HPV screening plus LBC co-testing in diagnosis of CIN2+ were calculated and compared among different age groups.@*Results@#Among the whole population, the detection rates of primary HR-HPV screening and HR-HPV screening plus LBC co-testing are 3.05% (879 CIN2+) and 3.13%(900 CIN2+), respectively. The sensitivity were 96.4% and 98.7% (χ2=19.00, P<0.001), and the specificity were 86.2% and 78.8% (χ2=2 067.00, P<0.001), respectively. Areas under the receiver operating characteristic (ROC) curve (AUC) showed that the primary HR-HPV screening performed better than co-testing (AUC were 0.913 and 0.888; Z=6.16, P<0.001). Compared with primary HR-HPV screening, co-testing showed significantly higher colposcopy referral rates (16.5% and 23.6%, respectively, χ2=132.00, P<0.001) and the number of colposcopy examination for detecting per CIN2+ (5.4 and 7.6, respectively).In the group aged 25-29, the colposcopy referral rates was 8.7 (10.9%(199 cases) vs 1.3%(23 cases)) times as much as the detection rate of primary HR-HPV screening in diagnosis of CIN2+, and was 12.5 (15.7%(288 cases) vs 1.3%(23 cases)) times as much as the detection rate of HR-HPV screening plus cytology contesting.@*Conclusion@#Compared with primary HR-HPV screening, HR-HPV screening plus cytology co-testing does not show better results in the screening performance for CIN2+ detection, and the cost-effectiveness is not good enough, especially in younger age group.
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0.05).Conclusions:The incidence of CIN and especially high-grade CIN are higher in patients with positive high risk types of HPV-DNA than negative. HPV-DNA testing has significance in the diagnosis of cervical displasia;HPVDNA testing combined with pap smear and colposcopy can increase the diagnosis of cervical diaplasia.
ABSTRACT
OBJECTIVE To evaluate the value of HPV-DNA test in the screening of cerical lesions.METHODS Patients with cervical lesions were detected by HPV-DNA test Papanicolaou(Pap) smear and pathological inspection,and the pathological results were regarded as gold standard.From the 178 positive cases,we compared the sensitivity of HPV-DNA test and Pap smear,and the HPV-DNA detection rate from patients with different histocytological classification.RESULTS All of 178 cases were positive in pathological inspection,the HPV-DNA test sensitivity was 85.4%,whereas Pap smear was 50.6%,the difference between HPV-DNA test and Pap smear was significant(P