A comprehensive evaluation of the accuracy of cervical pre-cancer detection methods in a high-risk area in East Congo

作者：Hovland S^*; Arbyn M; Lie A K; Ryd W; Borge B; Berle E J; Skomedal H; Kadima T M; Kyembwa L; Billay E M; Mukwege D; Chirimwami R B; Mvula T M; Snijders P J; Meijer C J L M; Karlsen F

来源：British Journal of Cancer, 2010, 102(6): 957-965.

DOI：10.1038/sj.bjc.6605594

• CIN
• PreTect HPV-Proofer
• E6/E7 mRNA
• HPV DNA
• RLB
• Africa

BACKGROUND: Given the high burden of cervical cancer in low-income settings, there is a need for a convenient and affordable method for detecting and treating pre-cancerous lesions.
METHODS: Samples for comparing the accuracy of cytology, virology and histology were collected. Identification of HPV E6/E7 mRNA was performed using PreTect HPV-Proofer. HPV DNA detection was performed by GP5 + /6 + PCR, followed by reverse line blot (RLB) for typing.
RESULTS: A total of 343 women, aged 25-60 years, attending gynaecological polyclinics in DR Congo were included for sample enrolment. The test positivity rate was conventional and liquid-based cytology (LBC) at cutoff ASCUS + of 6.9 and 6.6%, respectively; PreTect HPV-Proofer of 7.3%; and consensus DNA PCR for 14 HR types of 18.5%. Sixteen cases of CIN2 + lesions were identified. Of these, conventional cytology identified 66.7% with a specificity of 96.2%, LBC identified 73.3% with a specificity of 96.9%, all at cutoff ASCUS +. HR-HPV DNA detected all CIN2 + cases with a specificity of 85.9%, whereas PreTect HPV-Proofer gave a sensitivity of 81.3% and a specificity of 96.6%.
CONCLUSION: Both HPV detection assays showed a higher sensitivity for CIN2 + than did cytological methods. Detecting E6/E7 mRNA from only a subset of HR HPVs, as is the case with PreTect HPV-Proofer, resulted in a similar specificity to cytology and a significantly higher specificity than consensus HR HPV DNA (P < 0.0001). British Journal of Cancer (2010) 102, 957-965. doi:10.1038/sj.bjc.6605594 www.bjcancer.

• 出版日期2010-3-16