ABSTRACT
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.
ABSTRACT
Objective To evaluate the diagnostic value of thinprep cytologic test (TCT) combined with high-risk human papillomavirus (HR-HPV) DNA for cervical cancer (CC). Methods 141 cases of patients with abnormal cervical lesions were abnormal examined by TCT and were graded by the results of TCT and cervical biopsy, the HR-HPV-DNA was detected by surface plasmon resonance (SPR). Results The cervical biopsy positive rate 65.2% (92/141) was significantly higher than the positive rate of TCT 39.0% (55/141) (χ2=19.45, P < 0.05). The positive rate of HR-HPV-DNA was 66.0% (93/141) was significantly higher than the positive rate of TCT 39.0% (55/141), (χ2=20.53, P < 0.05). Conclusion TCT, HR-HPV-DNA and cervical biopsy are important clinical diagnostic methods for cervical lesions, combine detection of TCT and HR-HPV-DNA can improve the detection rate of cervical lesions.