PDF(Pubmed)
Abstract：
BACKGROUND: High-risk human papillomavirus (hrHPV) detection in self-collected urine samples (SeCUS) may be a promising alternative for cervical cancer screening because of its greater acceptability, as long as it can offer comparable sensitivity to clinician-collected cervical samples (CCoS) for detecting precancer lesions.
OBJECTIVE: To evaluate the performance of the SeCUS compared to that of the CCoS for cervical intraepithelial neoplasia grade 3 (CIN3) detection among hrHPV-positive women receiving colposcopy in Mexico City using different specific extended HPV typing procedures: HPV16/18, HPV16/18/35/39/68 or HPV16/18/35/39/68/31.
METHODS: From March 2017 to August 2018, 4,158 female users of the cervical cancer screening program at Tlalpan Sanitary Jurisdiction in Mexico City were invited to participate in the FRIDA-Tlalpan study. All participants provided ≥ 30 mL of SeCUS, and then a CCoS was obtained with Cervex-Brush®, which was used for hrHPV typing. Participants who tested positive for hrHPV in CCoS were referred for colposcopy for diagnostic confirmation, and all SeCUS of these women were also tested for hrHPV typing.
RESULTS: In total, 561 hrHPV-positive women were identified by CCoS via colposcopy, and 82.2% of the SeCUS of these women were also hrHPV positive. From both CCoS and SeCUS, 7 cases of CIN3 were detected. Considering HPV16/18 typing, CCoS and SeCUS detected 4 cases of CIN3, but after HPV16/18/35/39/68/31 extension typing, both CCoS and SeCUS detected all 7 of the CIN3 cases among the hrHPV-positive women.
CONCLUSIONS: Using extended hrHPV typing based on HPV16/18/35/39/68/31, our results suggest that the performance of SeCUS may be equivalent to that of CCoS for detecting CIN3 lesions. Although our results are inconclusive, they support the hypothesis that SeCUS may be an attractive alternative worthy of further research.
OBJECTIVE: To evaluate the performance of the SeCUS compared to that of the CCoS for cervical intraepithelial neoplasia grade 3 (CIN3) detection among hrHPV-positive women receiving colposcopy in Mexico City using different specific extended HPV typing procedures: HPV16/18, HPV16/18/35/39/68 or HPV16/18/35/39/68/31.
METHODS: From March 2017 to August 2018, 4,158 female users of the cervical cancer screening program at Tlalpan Sanitary Jurisdiction in Mexico City were invited to participate in the FRIDA-Tlalpan study. All participants provided ≥ 30 mL of SeCUS, and then a CCoS was obtained with Cervex-Brush®, which was used for hrHPV typing. Participants who tested positive for hrHPV in CCoS were referred for colposcopy for diagnostic confirmation, and all SeCUS of these women were also tested for hrHPV typing.
RESULTS: In total, 561 hrHPV-positive women were identified by CCoS via colposcopy, and 82.2% of the SeCUS of these women were also hrHPV positive. From both CCoS and SeCUS, 7 cases of CIN3 were detected. Considering HPV16/18 typing, CCoS and SeCUS detected 4 cases of CIN3, but after HPV16/18/35/39/68/31 extension typing, both CCoS and SeCUS detected all 7 of the CIN3 cases among the hrHPV-positive women.
CONCLUSIONS: Using extended hrHPV typing based on HPV16/18/35/39/68/31, our results suggest that the performance of SeCUS may be equivalent to that of CCoS for detecting CIN3 lesions. Although our results are inconclusive, they support the hypothesis that SeCUS may be an attractive alternative worthy of further research.
摘要：
背景：自我收集尿液样本（SeCUS）中的高危型人乳头瘤病毒（hrHPV）检测可能是宫颈癌筛查的一种有希望的替代方法，因为它具有更大的可接受性，只要它能够提供与临床医生收集的宫颈样本（CCoS）相当的灵敏度来检测癌前病变。
目的：在墨西哥城接受阴道镜检查的hrHPV阳性妇女中，使用不同的特定扩展HPV分型程序，评估SeCUS与CCoS在宫颈上皮内瘤变3级（CIN3）检测中的性能：HPV16/18，HPV16/18/35/39/68或HPV16/18/35/39/68/31。
方法：从2017年3月至2018年8月，墨西哥城Tlalpan卫生管辖区的宫颈癌筛查计划的4,158名女性用户被邀请参加FRIDA-Tlalpan研究。所有参与者提供≥30mLSeCUS，然后用Cervex-Brush®获得CCoS，用于hrHPV分型。在CCoS中检测出hrHPV阳性的参与者被转诊为阴道镜检查以进行诊断确认。所有这些女性的SeCUS也进行了hrHPV分型检测。
结果：总计，561hrHPV阳性的妇女通过CCoS通过阴道镜检查，这些女性的SeCUS中有82.2%也是hrHPV阳性。从CCoS和SeCUS，检测到7例CIN3。考虑到HPV16/18打字，CCoS和SeCUS检测到4例CIN3，但在HPV16/18/35/39/68/31扩展分型后，CCoS和SeCUS在hrHPV阳性女性中检测到所有7例CIN3病例.
结论：使用基于HPV16/18/35/39/68/31的扩展hrHPV分型，我们的结果表明，SeCUS的性能可能等同于CCoS检测CIN3病变。虽然我们的结果尚无定论，他们支持以下假设：SeCUS可能是值得进一步研究的有吸引力的替代方案。
目的：在墨西哥城接受阴道镜检查的hrHPV阳性妇女中，使用不同的特定扩展HPV分型程序，评估SeCUS与CCoS在宫颈上皮内瘤变3级（CIN3）检测中的性能：HPV16/18，HPV16/18/35/39/68或HPV16/18/35/39/68/31。
方法：从2017年3月至2018年8月，墨西哥城Tlalpan卫生管辖区的宫颈癌筛查计划的4,158名女性用户被邀请参加FRIDA-Tlalpan研究。所有参与者提供≥30mLSeCUS，然后用Cervex-Brush®获得CCoS，用于hrHPV分型。在CCoS中检测出hrHPV阳性的参与者被转诊为阴道镜检查以进行诊断确认。所有这些女性的SeCUS也进行了hrHPV分型检测。
结果：总计，561hrHPV阳性的妇女通过CCoS通过阴道镜检查，这些女性的SeCUS中有82.2%也是hrHPV阳性。从CCoS和SeCUS，检测到7例CIN3。考虑到HPV16/18打字，CCoS和SeCUS检测到4例CIN3，但在HPV16/18/35/39/68/31扩展分型后，CCoS和SeCUS在hrHPV阳性女性中检测到所有7例CIN3病例.
结论：使用基于HPV16/18/35/39/68/31的扩展hrHPV分型，我们的结果表明，SeCUS的性能可能等同于CCoS检测CIN3病变。虽然我们的结果尚无定论，他们支持以下假设：SeCUS可能是值得进一步研究的有吸引力的替代方案。
