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Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology

BACKGROUND: In Norway, women with low-grade squamous intraepithelial lesions (LSIL) are followed up after six months in order to decide whether they should undergo further follow-up or be referred back to the screening interval of three years. A high specificity and positive predictive value (PPV) o...

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Autores principales: Sørbye, Sveinung Wergeland, Arbyn, Marc, Fismen, Silje, Gutteberg, Tore Jarl, Mortensen, Elin Synnøve
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168878/
https://www.ncbi.nlm.nih.gov/pubmed/21918682
http://dx.doi.org/10.1371/journal.pone.0024083
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author Sørbye, Sveinung Wergeland
Arbyn, Marc
Fismen, Silje
Gutteberg, Tore Jarl
Mortensen, Elin Synnøve
author_facet Sørbye, Sveinung Wergeland
Arbyn, Marc
Fismen, Silje
Gutteberg, Tore Jarl
Mortensen, Elin Synnøve
author_sort Sørbye, Sveinung Wergeland
collection PubMed
description BACKGROUND: In Norway, women with low-grade squamous intraepithelial lesions (LSIL) are followed up after six months in order to decide whether they should undergo further follow-up or be referred back to the screening interval of three years. A high specificity and positive predictive value (PPV) of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures. MATERIALS AND METHODS: At the University Hospital of North Norway, repeat cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in triage of women with ASC-US and LSIL. In this study, women with LSIL cytology in the period 2005–2008 were included (n = 522). Two triage methods were evaluated in two separate groups: repeat cytology only (n = 225) and HPV mRNA testing in addition to repeat cytology (n = 297). Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) was used as the study endpoint. RESULTS: Of 522 women with LSIL, 207 had biopsies and 125 of them had CIN2+. The sensitivity and specificity of repeat cytology (ASC-US or worse) were 85.7% (95% confidence interval (CI): 72.1, 92.2) and 54.4 % (95% CI: 46.9, 61.9), respectively. The sensitivity and specificity of the HPV mRNA test were 94.2% (95% CI: 88.7, 99.7) and 86.0% (95% CI: 81.5, 90.5), respectively. The PPV of repeat cytology was 38.4% (95% CI: 29.9, 46.9) compared to 67.0% (95% CI: 57.7, 76.4) of the HPV mRNA test. CONCLUSION: HPV mRNA testing was more sensitive and specific than repeat cytology in triage of women with LSIL cytology. In addition, the HPV mRNA test showed higher PPV. These data indicate that the HPV mRNA test is a better triage test for women with LSIL than repeat cytology.
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spelling pubmed-31688782011-09-14 Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology Sørbye, Sveinung Wergeland Arbyn, Marc Fismen, Silje Gutteberg, Tore Jarl Mortensen, Elin Synnøve PLoS One Research Article BACKGROUND: In Norway, women with low-grade squamous intraepithelial lesions (LSIL) are followed up after six months in order to decide whether they should undergo further follow-up or be referred back to the screening interval of three years. A high specificity and positive predictive value (PPV) of the triage test is important to avoid unnecessary diagnostic and therapeutic procedures. MATERIALS AND METHODS: At the University Hospital of North Norway, repeat cytology and the HPV mRNA test PreTect HPV-Proofer, detecting E6/E7 mRNA from HPV types 16, 18, 31, 33 and 45, are used in triage of women with ASC-US and LSIL. In this study, women with LSIL cytology in the period 2005–2008 were included (n = 522). Two triage methods were evaluated in two separate groups: repeat cytology only (n = 225) and HPV mRNA testing in addition to repeat cytology (n = 297). Histologically confirmed cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) was used as the study endpoint. RESULTS: Of 522 women with LSIL, 207 had biopsies and 125 of them had CIN2+. The sensitivity and specificity of repeat cytology (ASC-US or worse) were 85.7% (95% confidence interval (CI): 72.1, 92.2) and 54.4 % (95% CI: 46.9, 61.9), respectively. The sensitivity and specificity of the HPV mRNA test were 94.2% (95% CI: 88.7, 99.7) and 86.0% (95% CI: 81.5, 90.5), respectively. The PPV of repeat cytology was 38.4% (95% CI: 29.9, 46.9) compared to 67.0% (95% CI: 57.7, 76.4) of the HPV mRNA test. CONCLUSION: HPV mRNA testing was more sensitive and specific than repeat cytology in triage of women with LSIL cytology. In addition, the HPV mRNA test showed higher PPV. These data indicate that the HPV mRNA test is a better triage test for women with LSIL than repeat cytology. Public Library of Science 2011-08-30 /pmc/articles/PMC3168878/ /pubmed/21918682 http://dx.doi.org/10.1371/journal.pone.0024083 Text en Sørbye et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Sørbye, Sveinung Wergeland
Arbyn, Marc
Fismen, Silje
Gutteberg, Tore Jarl
Mortensen, Elin Synnøve
Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology
title Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology
title_full Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology
title_fullStr Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology
title_full_unstemmed Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology
title_short Triage of Women with Low-Grade Cervical Lesions - HPV mRNA Testing versus Repeat Cytology
title_sort triage of women with low-grade cervical lesions - hpv mrna testing versus repeat cytology
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168878/
https://www.ncbi.nlm.nih.gov/pubmed/21918682
http://dx.doi.org/10.1371/journal.pone.0024083
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