Triage of low‐grade squamous intraepithelial lesions using human papillomavirus messenger ribonucleic acid tests—A prospective population‐based register study
| Autor: | Kristian Reinholdt, Christian Munk, Kirsten E. Juul, Susanne K. Kjaer, Louise T. Thomsen, Christian Dehlendorff |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Denmark Squamous Intraepithelial Lesions Cytological Techniques Cervical intraepithelial neoplasia 03 medical and health sciences 0302 clinical medicine Cytology Humans Medicine Cumulative incidence Prospective Studies RNA Messenger Registries 030212 general & internal medicine Human papillomavirus Prospective cohort study Papillomaviridae Early Detection of Cancer Colposcopy Gynecology 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Obstetrics and Gynecology Cancer General Medicine Middle Aged Uterine Cervical Dysplasia medicine.disease Triage RNA Viral Female Neoplasm Grading business |
| Zdroj: | Acta Obstetricia et Gynecologica Scandinavica. 99:204-212 |
| ISSN: | 1600-0412 0001-6349 |
| DOI: | 10.1111/aogs.13741 |
| Popis: | INTRODUCTION The optimal clinical management of women diagnosed with low-grade squamous intraepithelial lesions (LSIL) during cervical cancer screening remains unclear. In this prospective cohort study, we compared the clinical performance of two human papillomavirus (HPV) mRNA tests for triage of women with LSIL in Denmark. MATERIAL AND METHODS In a nationwide pathology register, we identified women aged 23-65 years with LSIL during 2008-2012. We included women tested for HPV mRNA with the PreTect HPV Proofer test for five high-risk HPV types (n = 2176) or the Aptima assay for 14 high-risk HPV types (n = 426). Subsequent histological diagnoses of cervical intraepithelial neoplasia grades 2, 3 or cancer (CIN2+) were identified in the register. We calculated the sensitivity and specificity for CIN2+ at 18 and 36 months of follow up, and the cumulative incidence of CIN2+ among women testing positive and negative, overall and by age (23-29, 30-39, 40-65 years). RESULTS The proportion of women with a positive mRNA test at baseline was higher in women tested with Aptima (66.7%) than in women tested with Proofer (42.8%). After 18 months, Aptima had higher sensitivity for CIN2+ than Proofer (98% [95% CI 94% to 100%] vs 85% [95% CI 82% to 88%]), whereas Proofer showed higher specificity than Aptima (67% [95% CI 64% to 70%]) vs (40% [95% CI 33% to 46%]). Aptima had particularly low specificity in women aged |
| Databáze: | OpenAIRE |
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