Diagnostic value of conventional cytology and HR-HPV testing in the detection of high grade cervical intraepithelial neoplasia
Aim. To investigate the effectiveness of conventional cervical cytology and HPV-SRS testing in the detection of HSIL.Turanova O.V., Belokrinitskaya T.E.
Materials and methods. The study included 84 patients, who underwent conventional cervical cytology, HPV testing by self-sampling and physician-sampling, and colposcopy. Patients with abnormal colposcopy findings underwent a cervical biopsy. Statistical analysis was performed using Statistica 10 software. The prognostic value of diagnostic tests was assessed according to generally accepted formulas.
Results. The sensitivity of conventional cytology was 10%, specificity - 98.1%; physician-sampling for an HPV test - 50% and 74.1%; self-sampling for the HPV test - 70% and 57.4%, respectively. HPV-cytology co-testing with self-sampling of the vaginal sample had a sensitivity of 70%. A combination of colposcopy with the HPV test regardless of sampling technique resulted in a sensitivity of 80%; HPV-cytology co-testing with colposcopy demonstrated a specificity of 75.9%.
Conclusion. HPV testing using the self-sampling technique, both in combination with cytology and as a single method, allows the diagnosis of a larger number of patients with HSIL.
Keywords
high-risk human papillomavirus
HPV test
cytology
cervical dysplasia
References
- World Health Organization. Comprehensive Cervical Cancer Control. A guide to essential practice. 2nd ed. 2014. 408 р. Available at: http://www.who.int/iris/handle/10665/144785.
- World Health Organization. WHO guidance note: comprehensive cervical cancer prevention and control: a healthier future for girls and women. 2013. 13 р.
- Maver P.J., Poljak M. Primary HPV-based cervical cancer screening in Europe: implementation status, challenges, and future plans. Clin. Microbiol. Infect. 2019; 17. pii: S1198-743X(19)30491-4. https://dx.doi.org/10.1016/j.cmi.2019.09.006.
- Червов В.О., Артымук Н.В. Информированность и онкологическая настороженность к раку органов репродуктивной системы у женщин Кемеровской области. Фундаментальная и клиническая медицина. 2016; 1(1): 64–8. [Chervov V.O., Artymuk N.V. Gynecological cancer awareness in Kemerovo region. Fundamental and Clinical Medicine/Fundamental’naya i klinicheskaya meditsina. 2016; 1(1): 64-8.(in Russian)].
- Shaniqua L., Jeanne M.F. Update on prevention and screening of cervical cancer. World J. Clin. Oncol. 2014; 5(4): 744–52. https://dx.doi.org/10.5306/wjco.v5.i4.744.
- Ашрафян Л.А., Оводенко Д.Л. Основные трудности скрининга рака шейки матки. Акушерство и гинекология: новости, мнения, обучение. 2018; 1: 14–7. [Ashrafyan L.A., Ovodenko D.L.Cervical cancer screening key problems. Obstetrics and Gynecology: news, opinions, traning/Akusherstvo i ginekologiya: novosti, mneniya, obuchenie. 2018; (1): 14–7. (in Russian)].
- Koliopoulos G., Nyaga V.N., Santesso N. Cytology versus HPV testing for cervical cancer screening in the general population. Cochrane Database Syst. Rev. 2017; 8: CD008587. https://dx.doi.org/10.1002/14651858.CD008587.pub2.
- Sharma J., Toi P.Ch., Siddaraju N., Sundareshan M., Habeebullah S. A comparative analysis of conventional and SurePath liquid-based cervicovaginal cytology: A study of 140 cases. J. Cytol. 2016; 33(2): 80–4. https://dx.doi.org/10.4103/0970-9371.182525.
- Bosch F.X., Broker T.R., Forman D., Moscicki A.B., Gillison M.L., Doorbar J. et al. Comprehensive control of human papillomavirus infections and related diseases. Vaccine. 2013; 31(Suppl. 7): H1–31. https://dx.doi.org/10.1016/j.vaccine.2013.10.003.
- Katki H.A., Kinney W.K., Fetterman B., Lorey T., Poitras N.E., Cheung L. et al. Cervical cancer risk for 330,000 women undergoing concurrent HPV testing and cervical cytology in routine clinical practice at a large managed care organization. Lancet Oncol. 2011; 12(7): 663–72. https://dx.doi.org/10.1016/S1470-2045(11)70145-0.
- Wright T.C., Stoler M.H., Behrens C.M., Sharma A., Zhang G., Wright T.L. Primary cervical cancer screening with human papillomavirus: end of study results from the ATHENA study using HPV as the first-line screening test. Gynecol. Oncol. 2015; 136(2): 189–97. https://dx.doi.org/10.1016/j.ygyno.2014.11.076.
- Апгар Б.С., Броцман Г.Л., Шпицер М. Клиническая кольпоскопия. Практическое руководство. М.: Практическая медицина; 2014. 384 c. [Apgar B.S., Brotsman G.L., Shpitser M. Klinicheskaya kol’poskopiya. Prakticheskoe rukovodstvo. Moscow: Prakticheskaya meditsina; 2014. 384 p. (in Russian)].
- Ortiz A.P., Alejandro N., Pérez C.M., Otero Y., Soto-Salgado M., Palefsky J.M. et al. Acceptability of cervical and anal HPV self-sampling in a sample of hispanic women in Puerto Rico. P R Health Sci J. 2012; 31(4): 205–12.
- Ma’som M., Bhoo-Pathy N., Nasir N.H., Bellinson J., Subramaniam S., Ma Y. et al. Attitudes and factors affecting acceptability of self-administered cervicovaginal sampling for human papillomavirus (HPV) genotyping as an alternative to Pap testing among multiethnic Malaysian women. BMJ Open. 2016; 6(8): e011022. https://dx.doi.org/10.1136/bmjopen-2015-011022.
- Arbyn M., Verdoodt F., Snijders P.J., Verhoef V.M., Suonio E., Dillner L. et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol. 2014; 15(2): 172-83. https://dx.doi.org/10.1016/S1470-2045(13)70570-9.
- Белокриницкая Т.Е., Фролова Н.И., Туранова О.В., Плетнёва В.А., Пальцева Т.В., Низелькаева Л.Ю. Самостоятельный vs врачебный забор материала для ВПЧ-теста: результативность и приемлемость у пациенток разных возрастных групп. Доктор.Ру. 2017; 7: 8-14. [Belokrinitskaya T.E., Frolova N.I., Turanova O.V., Pletneva V.A., Paltseva T.V., Nizelkaeva L.Yu. Self-sampling vs physician sampling for HPV testing: informative value and acceptability in female patients of various ages. Doktor.ru. 2017; 7: 8-14.(in Russian)].
- Toliman P., Badman S.G., Gabuzzi J., Silim S., Forereme L., Kumbia A. et al. Field evaluation of Xpert HPV point-of-care test for detection of human papillomavirus infection by use of self-collected vaginal and clinician-collected cervical specimens. J. Clin. Microbiol. 2016; 54(7): 1734-7. 10.1128/JCM.00529-16.
- De Thurah L., Bonde J., Lam J.U., Rebolj M. Concordant testing results between various human papillomavirus assays in primary cervical cancer screening: systematic review. Clin. Microbiol. Infect. 2018; 24(1): 29-36. https://dx.doi.org/10.1016/j.cmi.2017.05.020.
- Jentschke M., Chen K., Arbyn M., Hertel B., Noskowicz M., Soergel P., Hillemanns P. Direct comparison of two vaginal self-sampling devices for the detection of human papillomavirus infections. J. Clin.Virol. 2016; 82: 46-50. https://dx.doi.org/10.1016/j.jcv.2016.06.016.
- Balasubramanian A., Kulasingam S.L., Baer A., Hughes J.P., Myers E.R., Mao C. et al. Accuracy and cost-effectiveness of cervical cancer screening by high-risk human papillomavirus DNA testing of self-collected vaginal samples. J. Lower Genit. Tract Dis. 2010; 14(3): 185-95. https://dx.doi.org/10.1097/LGT.0b013e3181cd6d36.
- Szarewski A., Cadman L., Mallett S., Austin J., Londesborough P., Waller J. et al. Human papillomavirus testing by self-sampling: assessment of accuracy in an unsupervised clinical setting. J. Med. Screen. 2007; 14(1): 34-42.
- Bruni L., Albero G., Serrano B., Mena M., Gómez D., Muñoz J. et al. ICO Information Centre on HPV and Cancer (HPV Information Centre). Human papillomavirus and related diseases in the world. Summary Report 17 June 2019. Available at: https://www.hpvcentre.net/statistics/reports/XWX.pdf
- Blatt A.J., Kennedy R., Luff R.D., Austin R.M., Rabin D.S. Comparison of cervical cancer screening results among 256,648 women in multiple clinical practices. Cancer Cytopathol. 2015; 123(5): 282-8. https://dx.doi.org/10.1002/cncy.21544.
- Mustafa R.A., Santesso N., Khatib R., Mustafa A.A., Wiercioch W., Kehar R. et al. Systematic reviews and metaanalyses of the accuracy of HPV tests, visual inspection with acetic acid, cytology, and colposcopy. Int. J. Gynaecol. Obstet. 2016; 132(3): 259-65. https://dx.doi.org/10.1016/j.ijgo.2015.07.024.
Received 12.12.2020
Accepted 21.12.2020
About the Authors
Turanova Oxana V., postgraduate student of Obstetrics and Gynecology Department, Chita State Medical Academy, Ministry of Health of Russian.Email: oksana-kryzhnova@mail.ru
672000, Russia, Chita, Gorky str. 39a.
Tatiana E. Belokrinitskaya, MD, PhD, Professor, the Head of the Obstetrics and Gynecology Department, Chita State Medical Academy, Ministry of Health of Russian.
Email: tanbell24@mail.ru
672000, Russia, Chita, Gorky str. 39a.
For citation: Turanova O.V., Belokrinitskaya T.E. Diagnostic value of conventional cytology and HR-HPV-testing in the detection of high grade cervical intraepithelial neoplasia.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 1(Suppl): 93-7.(in Russian)
https://dx.doi.org/10.18565/aig.2020.1suppl.93-97
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