Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2009, Vol. 05 ›› Issue (01): 18 -22. doi: 10.3877/cma.j.issn.1673-5250.2009.01.107

Original Article

Prospective Cohort Research on Cervical Carcinoma Screening of Thinprep Cytological Test Combined With Human Papilloma Virus Hybrid Capture Ⅱ

Ping LIU, Yan-li LIU   

  1. Department of Obstetrics and Gynecology, Hexian Memorial Hospital, Guangzhou 511400, China
  • Published:2009-02-01
  • Supported by:
    * Project No. 2007–YB–189, supported by the Guangzhou Medicine Health Science and Technology
Objective

To investigate the screening value of the thinprep cytological test(TCT) detection combined with human papilloma virus(HPV) hybrid capture Ⅱ(HC-Ⅱ) for cervical carcinoma.

Methods

From January 2003 to January 2005, the thinprep cytological test and hybrid capture Ⅱ were applied to screen cervical carcinoma in 435 cases in the Department of Obstetrics and Gynecology in Hexian Memorial Hospital. The thinprep cytological test was applied to detect cervical carcinoma cytology, and hybrid capture Ⅱ was applied to detect human papilloma virus. According to the detection results, all cases were divided into 4 groups, group of HPV(-), TCT(-), group of HPV(+ ), TCT(-), group of HPV(-), TCT(+ ), group of HPV(+ ), TCT(+ ). A follow-up of 3 years had been carried out, and different groups were checked by the thinprep cytological test and human papilloma virus hybrid capture Ⅱ at different interval times, and colpomicroscope, biopsy and endocervical curettage (ECC) would also be used if necessary. Determinant elements of cytology occurrence were evaluated by the Logistic regression analysis.

Results

The sensitivity, specificity, efficiency, positive predictive value (PPV), negative predictive value(NPV), Kappa values of the thinprep cytological test and human papilloma virus hybrid capture Ⅱwere 85.9%, 96.2%, 94.7%, 79.7%, 97.5%, 0.7959, and 92.2%, 80.1%, 81.8%, 44.4%, 98.3%, 0.4996. The group of HPV(+ ), TCT(-), and the group of HPV(-), TCT(+ ) had higher risk of pathological changes of cervical carcinoma (RR=45.033, 95%CI 17.140~118.313; RR=235.886, 95% CI 70.694~487.088) compared with the group of HPV(-), TCT(-), and the group of HPV(+ ), TCT(+ ) had distinct risks (RR=464.400, 95% CI 105.162~950.806).

Conclusion

The detection of sensitivity and specificity by the combination of the thinprep cytological test with human papilloma virus hybrid capture Ⅱ can be enhanced, which could meet the requirement of screening the early stage of cervical carcinomas and precancerous changes.

1 Simsir A, Ioffe OB, Bourquin P, et al. Repeat cervical cytology at the time of colposcopy. Is there an added benefit? Acta Cytol, 2001, 45(1):23–27.
2 Wright TC Jr, Cox JT, Massad LS, et al. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia. AJOG, 2003,189(1):295–304.
3 Gornall RJ, Boyd IE, Manolitsas T, et al. Interval cervical cancer following treatment for cervical intraepithelial neoplasia. Int J Gynecol Cancer, 2000, 10(3):198–202.
4 Spitzer M, Apgar BS, Brotzman GL. Management of histologic abnormalities of the cervix. Am Fam Physician, 2006, 73(1): 105–112.
5 Wang N, Emancipator SN, Rose P, et al. Histologic follow–up of atypical endocervical cells. Liquid–based, thin–layer preparation vs. conventional papsmear. Acta Cytologica, 2002, 46(3):453–456.
6 Gupta D, Kannan V, Komaromy–Hiller G, et al. ASCUS, mature metaplastic type. Cytologic diagnosis and follow–up. Acta Cytocolgica, 2001, 45(2):192–196.
7 Alves VA, Bibbo M, Schmitt FC, et al. Comparison of manual and automated methods of liquid–based cytology. A morphologic study. Acta Cytol, 2004, 48(2): 187–193.
8 Lonky NM, Navarre GL, Saunders S, et al. Low–grade papanicolaou smears and the bethesda system:A prospective cytohistopathologic analysis. Obstet Gynecol, 1995, 85(5 pt 1):716–721.
9 Bernstein SJ, Sanchez–Ramos L, Ndubisi B. Liquid–based cervical cytologic smear study and conventional Papanicolaou smears: A meta–analysis of prospective studies comparing cytologic diagnosis and sample adequacy. Am J Obstet Gynecol, 2001,185(2):308–317.
10 Pan Q, Belinson JL, Li L, et al. A thin–layer, liquid–based pap test for mass screening in an area of China with a high incidence of cervical carcinoma. A cross–sectional, comparative study. Acta Cytol, 2003, 47(1):45–50.
11 Bosch FX, Manos MM, Munöz N, et al. Prevalence of human papillomavirus in cervical cancer: A worldwide perspective. International Biological Study on Cervical Cancer (IBSCC) Study Group. J Natl Cancer Inst, 1995, 87(11):796–802.
12 Munoz N, Bosch FX, de Sanjose S, et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med, 2003, 348(6):518–527.
13 Azodi M, Chambers SK, Rutherford TJ, et al. Adenocarcinoma in situ of the cervix: Management and outcome. Gynecol Oncol, 1999, 73(3): 348–353.
14 Hernández–Hernández DM, Ornelas–Bernal L, Guido–Jiménez M, et al. Association between high–risk human papillomavirus DNA load and precursor lesions of cervical cancer in Mexican women. Gynecol Oncol, 2003, 90(2): 310–317.
15 Cogliano V, Baan R, Straif K, et al. Carcinogenicity of human papillomaviruses. Lancet Oncol, 2005, 6(4):204.
16 Khan MJ, Castle PE, Lorincz AT, et al. The elevated 10–year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type–specific HPV testing in clinical practice. J Natl Cancer Inst, 2005, 97(14):1072–1079.
17 Cen JM, Qian DY, Wang D, et al. Evaluation of high–risk HPV testing in triage of patients with atypical squamous cells of undetermined significance. Chin J Obs/Gynecol & Pediatr(Electronic Version), 2006, 2(1):12–14.[岑坚敏,钱德英,王丁,等. 高危型人类乳头瘤病毒检测对不典型鳞状细胞分流监测的临床价值. 中华妇幼临床医学杂志:电子版,2006,2(1):12–14.]
18 Nobbenhuis MA, Walboomers JM, Helmerhorst TJ, et al. Relation of human papillomavirus status to cervical lesions and consequences for cervical–cancer screening:A prospective study. Lancet, 1999, 354(9172):20–25.
19 Sun CA, Liu JF, Wu DM, et al. Viral load of high–risk human papillomavirus in cervical squamous intraepithelial lesions. Int J Gynaecol Obstet, 2002, 76(1):41–47.
20 Clavel C, Masure M, Bory JP, et al. Human papillomavirus testing in primary screening for the detection of high–grade cervical lesions:A study of 7 932 women. Br J Cancer, 2001, 84(12):1616–1623.
21 Kuhn L, Denny L, Pollack A, et al. Human papillomavirus DNA testing for cervical cancer screening in low–resource settings. J Natl Cancer Inst, 2000, 92(10):818–825.
22 Strickler HD, Palefsky JM, Shah KV, et al. Human papillomavirus type 16 and immune status in human immunodeficiency virus–seropositive women. J Natl Cancer Inst, 2003, 95(14):1062–1071.
23 Screening and cloning of the down–regulation gene by recombinant interferon–B using suppression subtractive hybridization technique. Zhonghua Shi Yan He Lin Chuang Bing Du Xue Za Zhi, 2006, 20(3): 273–275.
24 Wright TC Jr, Cox JT, Massad LS, et al. 2001 Consensus guidelines for the management of women with cervical cytological abnormalities. JAMA, 2002, 287(16):2120–2129.
25 Belinson JL, Qiao YL, Pretorius RG, et al. Shanxi Province cervical cancer screening study Ⅱ:Self–sampling for high–risk human papillomavirus compared to direct sampling for human papillomavirus and liquid based cervical cytology. Int J Gynecol Cancer, 2003, 13(6):819–826.
26 Qiao YL, Zhang WH, Li L, et al. The cross sectional study in screening cervical carcinoma. Acta Academiae Med Sinicae, 2002, 24(1):50–53.[乔友林,章文华,李凌,等. 子宫颈癌筛查方法的横断面比较研究. 中国医学科学院学报,2002, 24(1):50–53.]
27 Lorincz AT, Richart RM. Human papillomavirus DNA testing as an adjunct to cytology in cervical screening programs. Arch Pathol Lab Med, 2003, 127(8):959–968.
28 Lorenzato F, Singer A, Mould T, et al. Cervical cancer detection by hybrid capture and evaluation of local risk factors. Int J Gynaecol Obstet, 2001, 73(1):41–46.
29 Saslow D, Runowicz CD, Solomon D, et al. American Cancer Society guideline for the early detection of cervical neoplasia and cancer. CA Cancer J Clin, 2002, 52(6):342–362.
30 Ho L, Terry G, Londesborough P, et al. Human papillomavirus DNA detection in the management of women with twice mildly abnormal cytological smears. J Med Virol, 2003, 69(1):118–121.
[1] Jiu Wang, Jun Chen, Xia Zhu, Yangjin Mima, Sheng Zhao, Xinlin Chen, Jianhua Li, Shuang Wang. Effect of implementing fetal systemic ultrasound screening in Material and Child Health Hospital of Shannan[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(07): 728-733.
[2] Ling Wei, Hui Li, Yi Chen. Current research status on colonization or infection and mother-to-child transmission of extended-spectrum β-lactamase-producing Enterobacteriaceae in pregnant and post-partum women[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 517-521.
[3] Haolin Zhang, Xu Zhang, Kun Liang, Zuolin Jin, Jie Gao. Advances in diagnosis and screening of adenoid hypertrophy in children[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2023, 17(02): 123-127.
[4] Yanqing Gao, Fei Han, Huaijun Zhu, Peng Song, Liang Tao, Wenxian Guan, Xiaojie Bian. Applicability of nutritional risk screening and assessment in patients undergoing surgery for gastric cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(02): 167-171.
[5] Xiaojuan Li, Weijia Li, Lingyan Peng, Pengying Zhou, Gui'e Li, Xiangchen Liu. Analysis of the clinical characters of prostate calcification in physical examination population[J]. Chinese Journal of Endourology(Electronic Edition), 2023, 17(04): 336-338.
[6] Kai Yan, Yong Fu, Zhengtao Zhang. Predictive model of therapeutic effect of middle and advanced liver cancer and research progress of organoid models of liver cancer[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(03): 348-351.
[7] Hongzhi Liu, Jingfeng Liu. Application of big data and artificial intelligence in screening and diagnosis of primary liver cancer[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(01): 1-5.
[8] Wenqi Sun, Xinrong Wu, Yunrong Wang, Bei Zhao, Xiaotan Dou, Wen Li, Xiaoping Zou, Lei Wang, Min Chen. The value of measuring ROS and FH in colorectal epithelial cells for colorectal cancer screening[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(04): 326-330.
[9] Yimin E, Sizheng Sun, Xiaoyu Fan, Chunzhao Yu. Present status and prospect of fecal screening for colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(04): 331-336.
[10] Qian Liu, Wei Cui, Yibo Gao, Zeyue Zhang, Diange Li, Zhijie Wang, Jie Wang, Jie He, Expert Group of China Guideline for the Screening and Early Diagnosis and Treatment of Colorectal Cancer. New screening strategies for early colorectal tumors: a screening protocol based on liquid biopsy techniques[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2023, 12(01): 17-20.
[11] Jingke Li, Yanchun Zhang, Jiayi Wu, Xiuyu Ren. Deep learning for diabetic retinopathy screening, classification and management[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2023, 13(04): 241-246.
[12] Chenxi Zong, Lin Xiao, Hongxin Song. Advances and prospects in the application of artificial intelligence vision screening in the prevention and control of myopia[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2023, 13(01): 60-64.
[13] Wenjie Li, Hong Lu. Research progress of uveitis associated with juvenile idiopathic arthritis[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2023, 13(01): 40-44.
[14] Hang Xu, Yutao Cui, Guangkai Ren, He Liu, Yanbing Wang, Chuangang Peng, Dankai Wu. Screening and Bioinformatics Analysis of Core Genes of Osteoporosis[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(01): 18-22.
[15] Xin Jiang, Chun Pan, Wenhui Huang, Guifen Gan. A study on active CRE screening and CRE infection in anal swabs in Intensive Care Units in Qinghai area[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2023, 09(02): 178-184.
Viewed
Full text


Abstract