8 research outputs found
Genotyping for Human Papillomavirus (HPV) 16/18/52/58 Has a Higher Performance than HPV16/18 Genotyping in Triaging Women with Positive High-risk HPV Test in Northern Thailand.
Testing for high-risk human papillomavirus DNA (HPV test) has gained increasing acceptance as an alternative method to cytology in cervical cancer screening. Compared to cytology, HPV test has a higher sensitivity for the detection of histologic high-grade squamous intraepithelial lesion or worse (HSIL+), but this could lead to a large colposcopy burden. Genotyping for HPV16/18 has been recommended in triaging HPV-positive women. This study was aimed to evaluate the screening performance of HPV testing and the role of genotyping triage in Northern Thailand.A population-based cervical screening program was performed in Chiang Mai (Northern Thailand) using cytology (conventional Pap test) and HPV test (Hybrid Capture 2). Women who had abnormal cytology or were HPV-positive were referred for colposcopy. Cervical samples from these women were genotyped using the Linear Array assay.Of 5,456 women, 2.0% had abnormal Pap test results and 6.5% tested positive with Hybrid Capture 2. Of 5,433 women eligible for analysis, 355 with any positive test had histologic confirmation and 57 of these had histologic HSIL+. The sensitivity for histologic HSIL+ detection was 64.9% for Pap test and 100% for Hybrid Capture 2, but the ratio of colposcopy per detection of each HSIL+ was more than two-fold higher with Hybrid Capture 2 than Pap test (5.9 versus 2.8). Genotyping results were available in 316 samples. HPV52, HPV16, and HPV58 were the three most common genotypes among women with histologic HSIL+. Performance of genotyping triage using HPV16/18/52/58 was superior to that of HPV16/18, with a higher sensitivity (85.7% versus 28.6%) and negative predictive value (94.2% versus 83.9%).In Northern Thailand, HPV testing with genotyping triage shows better screening performance than cervical cytology alone. In this region, the addition of genotyping for HPV52/58 to HPV16/18 is deemed necessary in triaging women with positive HPV test
Flowchart for the study population.
<p>Pap, Pap test; HC2, Hybrid Capture 2; HSIL+, histologic high-grade squamous intraepithelial lesion or worse lesions.</p
Histologic diagnoses in 316 women with available histology and genotyping results.
<p>Histologic diagnoses in 316 women with available histology and genotyping results.</p
Triaging 307 women with positive Hybrid Capture 2 and available genotyping results using different methods.
<p>Triaging 307 women with positive Hybrid Capture 2 and available genotyping results using different methods.</p
Comparison of diagnostic odds ratios of triage methods in 307 women with positive Hybrid Capture 2 and HPV genotyping.
<p>Comparison of diagnostic odds ratios of triage methods in 307 women with positive Hybrid Capture 2 and HPV genotyping.</p
Receiver operating curve analysis comparing triage methods in 307 women with positive Hybrid Capture 2.
<p>(A) triage using cytology or genotyping (p<0.001). (B) triage using combined genotyping and cytology (p = 0.055).</p
Genotype distribution in 263 women with infections of 13 high-risk HPV genotypes.
<p>Genotype distribution in 263 women with infections of 13 high-risk HPV genotypes.</p