Combined Pap Smear, Cervicography and HPV DNA Testing in the Detection of Cervical Intraepithelial Neoplasia and Cancer
| Autor: | A C Finarelli, Alessandra Zamparelli, Mario Sideri, Kari Syrjänen, Luciano Bovicelli, Silvano Costa, Patrizia Terzano, P Cristiani, Alessandro Bovicelli, M De Nuzzo, P De Simone |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
medicine.medical_specialty Histology Adolescent Uterine Cervical Neoplasms Cervix Uteri Endocervical curettage Cervical intraepithelial neoplasia Gastroenterology Pathology and Forensic Medicine Internal medicine medicine Humans Cervix neoplasm Papillomaviridae Aged Vaginal Smears Colposcopy Cervical cancer medicine.diagnostic_test business.industry Papillomavirus Infections Cancer General Medicine Papanicolaou Test Middle Aged Uterine Cervical Dysplasia medicine.disease female genital diseases and pregnancy complications Tumor Virus Infections DNA Viral Female Cervicography business |
| Zdroj: | Acta Cytologica. 44:310-318 |
| ISSN: | 1938-2650 0001-5547 |
| DOI: | 10.1159/000328471 |
| Popis: | Objective The sensitivity of the Pap smear (PAP) continues to be the subject of debate. During the past several years, cervicography (CER) and HPV DNA testing have been suggested as optional tools in the screening of cervical cancer precursors. Study design The performance characteristics of PAP, CER and HPV DNA testing (hybrid capture test [HCT]) in all potential combinations were evaluated in a series of 1,030 women (aged 16-70, median, 33), subjected to colposcopy (COLPO) as the reference tool. Results Of the 992 evaluable cases, 402/992 (41%) had positive COLPO (i.e., an abnormal transformation zone). Of them, 298 women underwent directed punch biopsy, while of the COLPO negative patients, 18/93 positive by at least one of the three tests had endocervical curettage. Of the 402 COLPO positive women, 146 (36%) remained negative on all tests, whereas 256 (64%) had at least one positive test. There were 84 cervical intraepithelial neoplasia (CIN) 2 and 3 lesions and 6 invasive carcinomas. Of the former, 10 were detected by PAP alone, 4 by CER alone and 3 by HCT alone. Three of the 6 carcinomas were HCT negative. The predictive value (PPV) of a positive test was 45% for PAP, 51% for CER and 48% for HCT. The combinations of PAP with CER (for PAP negative cases) and PAP with HCT were more sensitive for CIN 2 and 3 (95% and 94%, respectively) as compared with PAP alone but were associated with a significant decrease in specificity (44% and 46% vs. 57%, respectively). However, both combinations retained a PPV (43%) similar to that of PAP alone (45%). Conclusion The potential combinations of PAP with CER and with HCT were more sensitive in detecting CIN 2 and 3 as compared with PAP alone and retained a PPV similar to that of PAP. |
| Databáze: | OpenAIRE |
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