PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to measure the accuracy of optical coherence tomography (OCT) in the early diagnosis of high-grade cervical lesions and assess its diagnostic value in the triage of high-risk HPV infection.
UNASSIGNED: From Jan 2019 to Jan 2021, women who visited the gynecology clinics of 2 hospitals for colposcopy were invited to participate in this study. Women aged 35 to 64 years old who were sexually active and had an intact cervix with a diameter of more than or equal to 2 cm were included in this study. Additionally, individuals with abnormal cytology, positive HPV test results, or other clinically suspicious symptoms or signs were referred. All participants were examined before colposcopy using OCT. Biopsy and/or ECC were conducted under colposcopy. We used the results of histopathology as the gold standard and assessed the accuracy of OCT.
UNASSIGNED: Overall, 883 women were included in the analysis. Approximately 13.25% of women were ASCUS+ in cytological assessments, and 22.31% were positive for high-risk HPV. Nearly 15.18% of women were positive in OCT. Of them, 27 women were diagnosed with CIN2, and 33 were diagnosed with CIN3+ lesions. Among HPV-positive women, the detection rates for CIN2+ and CIN3+ were much lower for those who were negative in OCT, compared with NILM cytology (CIN2+: 20.0% vs. 30.0%, P=0.002, and CIN3+: 18.2% vs. 27.3%, P=0.013). Among women who were positive for HPV16/18, the detection rate for CIN2+ was much lower for negative OCT, compared with NILM cytology (8.3% vs.15.0%, P=0.005). Compared to HPV and cytological tests, HPV combined with OCT had higher specificity for detecting CIN2+ and CIN3+ (96.1% vs. 93.2%, P=0.002; 93.8% vs. 91.3%, P=0.013). OCT triage after HPV genotyping had the highest AUC for detecting CIN2+ and CIN3+ cases among patients with high-risk HPV infection (0.921, 0.920).
UNASSIGNED: OCT is an accurate test for the early diagnosis of high-grade cervical lesions and has great diagnostic value in the triage of patients with high-risk HPV infection.
UNASSIGNED: From Jan 2019 to Jan 2021, women who visited the gynecology clinics of 2 hospitals for colposcopy were invited to participate in this study. Women aged 35 to 64 years old who were sexually active and had an intact cervix with a diameter of more than or equal to 2 cm were included in this study. Additionally, individuals with abnormal cytology, positive HPV test results, or other clinically suspicious symptoms or signs were referred. All participants were examined before colposcopy using OCT. Biopsy and/or ECC were conducted under colposcopy. We used the results of histopathology as the gold standard and assessed the accuracy of OCT.
UNASSIGNED: Overall, 883 women were included in the analysis. Approximately 13.25% of women were ASCUS+ in cytological assessments, and 22.31% were positive for high-risk HPV. Nearly 15.18% of women were positive in OCT. Of them, 27 women were diagnosed with CIN2, and 33 were diagnosed with CIN3+ lesions. Among HPV-positive women, the detection rates for CIN2+ and CIN3+ were much lower for those who were negative in OCT, compared with NILM cytology (CIN2+: 20.0% vs. 30.0%, P=0.002, and CIN3+: 18.2% vs. 27.3%, P=0.013). Among women who were positive for HPV16/18, the detection rate for CIN2+ was much lower for negative OCT, compared with NILM cytology (8.3% vs.15.0%, P=0.005). Compared to HPV and cytological tests, HPV combined with OCT had higher specificity for detecting CIN2+ and CIN3+ (96.1% vs. 93.2%, P=0.002; 93.8% vs. 91.3%, P=0.013). OCT triage after HPV genotyping had the highest AUC for detecting CIN2+ and CIN3+ cases among patients with high-risk HPV infection (0.921, 0.920).
UNASSIGNED: OCT is an accurate test for the early diagnosis of high-grade cervical lesions and has great diagnostic value in the triage of patients with high-risk HPV infection.
摘要：
■本研究旨在测量光学相干断层扫描（OCT）在高级别宫颈病变早期诊断中的准确性，并评估其在高危型HPV感染分诊中的诊断价值。
从2019年1月至2021年1月，邀请到2家医院的妇科诊所进行阴道镜检查的妇女参加本研究。这项研究包括35至64岁的女性，她们性活跃，子宫颈完整，直径大于或等于2厘米。此外,细胞学异常的个体，HPV检测结果阳性,或其他临床可疑症状或体征被转介。所有参与者在阴道镜检查前使用OCT检查。在阴道镜下进行活检和/或ECC。我们使用组织病理学结果作为金标准，并评估OCT的准确性。
■总的来说，883名妇女被纳入分析。在细胞学评估中，约有13.25％的女性为ASCUS+，22.31%的高危型HPV阳性。在OCT中，近15.18%的女性为阳性。其中,27名女性被诊断为CIN2，33名被诊断为CIN3+病变。在HPV阳性女性中，对于OCT阴性的患者，CIN2+和CIN3+的检出率要低得多，与NILM细胞学相比（CIN2+：20.0%vs.30.0%,P=0.002，和CIN3+：18.2%vs.27.3%,P=0.013)。在HPV16/18阳性的女性中，对于阴性的OCT，CIN2+的检出率要低得多，与NILM细胞学相比（8.3%vs.15.0%，P=0.005)。与HPV和细胞学检查相比，HPV联合OCT检测CIN2+和CIN3+的特异性较高(96.1%vs.93.2%,P=0.002;93.8%vs.91.3%,P=0.013)。在高危型HPV感染患者中，HPV基因分型后的OCT分诊检测CIN2+和CIN3+病例的AUC最高（0.921，0.920）。
■OCT是宫颈高级别病变早期诊断的准确测试，对高危型HPV感染患者的分诊具有很大的诊断价值。
从2019年1月至2021年1月，邀请到2家医院的妇科诊所进行阴道镜检查的妇女参加本研究。这项研究包括35至64岁的女性，她们性活跃，子宫颈完整，直径大于或等于2厘米。此外,细胞学异常的个体，HPV检测结果阳性,或其他临床可疑症状或体征被转介。所有参与者在阴道镜检查前使用OCT检查。在阴道镜下进行活检和/或ECC。我们使用组织病理学结果作为金标准，并评估OCT的准确性。
■总的来说，883名妇女被纳入分析。在细胞学评估中，约有13.25％的女性为ASCUS+，22.31%的高危型HPV阳性。在OCT中，近15.18%的女性为阳性。其中,27名女性被诊断为CIN2，33名被诊断为CIN3+病变。在HPV阳性女性中，对于OCT阴性的患者，CIN2+和CIN3+的检出率要低得多，与NILM细胞学相比（CIN2+：20.0%vs.30.0%,P=0.002，和CIN3+：18.2%vs.27.3%,P=0.013)。在HPV16/18阳性的女性中，对于阴性的OCT，CIN2+的检出率要低得多，与NILM细胞学相比（8.3%vs.15.0%，P=0.005)。与HPV和细胞学检查相比，HPV联合OCT检测CIN2+和CIN3+的特异性较高(96.1%vs.93.2%,P=0.002;93.8%vs.91.3%,P=0.013)。在高危型HPV感染患者中，HPV基因分型后的OCT分诊检测CIN2+和CIN3+病例的AUC最高（0.921，0.920）。
■OCT是宫颈高级别病变早期诊断的准确测试，对高危型HPV感染患者的分诊具有很大的诊断价值。
