Defining Optimal Triage Strategies for hrHPV Screen–Positive Women—An Evaluation of HPV 16/18 Genotyping, Cytology, and p16/Ki-67 Cytoimmunochemistry
| Autor: | Grazyna A. Stanczuk, Timothy M. Palmer, Marc Arbyn, William Forson, Lynne Patterson, Janice Black, Gwen Baxter, Lynn Govan, Kate Cuschieri, Heather Currie, A. Wilson, James R. Lawrence |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Genotype Genotyping Techniques Epidemiology Uterine Cervical Neoplasms Sensitivity and Specificity Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine Cytology medicine Humans 030212 general & internal medicine Liquid biopsy Genotyping Cyclin-Dependent Kinase Inhibitor p16 Early Detection of Cancer Gynecology Colposcopy Human papillomavirus 16 Human papillomavirus 18 biology medicine.diagnostic_test business.industry Absolute accuracy Papillomavirus Infections Liquid Biopsy Middle Aged Uterine Cervical Dysplasia Immunohistochemistry Triage female genital diseases and pregnancy complications Cross-Sectional Studies Ki-67 Antigen 030220 oncology & carcinogenesis Ki-67 biology.protein Female business |
| Zdroj: | Stanczuk, G A, Baxter, G J, Currie, H, Forson, W, Lawrence, J R, Cuschieri, K, Wilson, A, Patterson, L, Govan, L, Black, J, Palmer, T & Arbyn, M 2017, ' Defining optimal triage strategies for hrHPV screen positive women-an evaluation of HPV 16/18 genotyping, cytology and p16/Ki-67 cyto-immunochemistry. ', Cancer Epidemiology, Biomarkers and Prevention, pp. cebp.0534.2017 . https://doi.org/10.1158/1055-9965.EPI-17-0534 |
| ISSN: | 1538-7755 1055-9965 |
| DOI: | 10.1158/1055-9965.epi-17-0534 |
| Popis: | Background: Several options for the triage of high-risk HPV screen–positive (hrHPV+) women were assessed. Methods: This study incorporated CIN2+ cases and controls, all of whom tested hrHPV+ and whose results of liquid-based cytology (LBC), HPV16/18 genotyping, and p16/Ki67 cytoimmunochemistry were available. Sensitivity and specificity for the CIN2+ of these triage tests were evaluated. Results: Absolute sensitivities of HPV 16/18 typing, LBC, and p16/Ki-67 cytoimmunochemistry for CIN2+ detection were 61.7%, 68.3%, and 85.0% for women with hrHPV+ clinician-taken samples. Respective specificities were 70.5%, 89.1%, and 76.7%. The absolute accuracy of the triage tests was similar for women with a hrHPV+ self-sample. P16/Ki-67 cyto-immunochemistry was significantly more sensitive than LBC although significantly less specific. Conclusions: All three single-test triage options, if positive, exceed the threshold of 20% risk at which colposcopy would be indicated. However, none of them conferred a post-test probability of CIN2+ Impact: This is one of the few studies to directly compare the performance of triage strategies of hrHPV+ women, in isolation and combinations. It is the only study assessing triage strategies in women who test hrHPV+ in self-taken vaginal samples. A combined triage option that incorporated HPV 16/18 typing prior to p16/ki-67 cytoimmunochemistry in HPV 16/18–negative women yielded a post-test probability of CIN2+ of >20%, whereas women who tested negative had a probability of CIN2+ of |
| Databáze: | OpenAIRE |
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