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首页> 外文期刊>Journal of Clinical Microbiology >Evaluation of Any or Type-Specific Persistence of High-Risk Human Papillomavirus for Detecting Cervical Precancer
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Evaluation of Any or Type-Specific Persistence of High-Risk Human Papillomavirus for Detecting Cervical Precancer

机译：高风险人类乳头瘤病毒对宫颈癌前病变的任何或特定类型持久性的评估。

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High-risk human papillomavirus (HR-HPV) testing is increasingly important. We therefore examined the impact on accuracy of repeated versus one-time testing, type-specific versus pooled detection, and assay analytic sensitivity. By using a nested case-control design from the ASCUS-LSIL Triage Study, we selected women with incident cervical intraepithelial neoplasia grade 2 or grade 3 (CIN2/3; n = 325) and a random sample of women with n = 401). HPV DNA status was assessed using hybrid capture 2 (HC2), a pooled test for 13 HR-HPV types, and the linear array (LA) and the line blot assay (LBA), two PCR-based HPV genotyping assays, at enrollment and the 6-month follow-up visit. The relative sensitivity and specificity for different permutations of multiple measurements were compared to a single measurement using marginal regression models. We found that repeat detection of any HR-HPV (by HC2, LA, or LBA) and of type-specific persistence (by LA or LBA) were significantly more specific but less sensitive than use of a single time point measurement of any HR-HPV. Sensitivity decreased and specificity increased further when testing intervals were increased from 12 to 24 months. Including detection of borderline carcinogeniconcarcinogenic HPV types with HR-HPV types decreased specificity for repeat measures of HPV with no impact on sensitivity. Similar patterns were observed when we used a CIN3 end point. We conclude that assay performance for detecting incident CIN2/3 was affected by which types were included, the analytic sensitivity of the assay, and the testing interval. These trade-offs need to be considered when assessing the potential overall clinical utility of repeated testing for HR-HPV DNA to identify women at risk for CIN2/3.
机译：高危人类乳头瘤病毒（HR-HPV）测试变得越来越重要。因此，我们检查了重复测试与一次性测试，类型特异性测试与合并检测以及测定分析灵敏度对准确性的影响。通过使用ASCUS-LSIL Triage研究的嵌套病例对照设计，我们选择了2级或3级（CIN2 / 3; n = 325）发生宫颈上皮内瘤样病变的妇女，并随机抽取了以 n = 401）。使用混合捕获2（HC2），13种HR-HPV类型的汇总测试以及线性阵列（LA）和线印迹测定（LBA），两种基于PCR的HPV基因分型测定来评估HPV DNA状态6个月的随访。使用边际回归模型，将多次测量的不同排列的相对灵敏度和特异性与一次测量进行了比较。我们发现，重复检测任何HR-HPV（通过HC2，LA或LBA）和类型特定的持久性（通过LA或LBA）比使用任何HR-HPV的单个时间点测量显着更特异性，但敏感性更低HPV。当测试间隔从12个月增加到24个月时，灵敏度降低，特异性进一步提高。包括用HR-HPV类型检测临界致癌/非致癌性HPV类型可降低对HPV重复检测的特异性，而不会影响敏感性。当我们使用CIN3端点时，观察到类似的模式。我们得出结论，检测事件CIN2 / 3的检测性能受以下因素影响：所包含的类型，检测的分析灵敏度和检测间隔。在评估重复测试HR-HPV DNA以确定潜在CIN2 / 3风险妇女的潜在整体临床效用时，需要考虑这些折衷。

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