Accuracy of triage strategies for human papillomavirus DNA-positive women in low-resource settings:

来源 :中国癌症研究(英文版) | 被引量 : 0次 | 上传用户:woshiwl0000
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Objective:CareHPV is a human papillomavirus (HPV) DNA test for low-resource settings (LRS).This study assesses optimum triage strategies for careHPV-positive women in LRS.Methods:A total of 2,530 Chinese women were concurrently screened for cervical cancer with visual inspection with acetic acid (VIA),liquid-based cytology and HPV testing by physician-and self-collected careHPV,and physician-collected Hybrid Capture 2 (HC2).Screen-positive women were referred to colposcopy with biopsy and endocervical curettage as necessary.HPV-positivity was defined as ≥1.0 relative light units/cutoff (RLU/CO) for both careHPV and HC2.Primary physician-HC2,physician-careHPV and self-careHPV and in sequential screening with cytology,VIA,or increased HPV test-posidvity performance,stratified by age,were assessed for cervical intraepithelial neoplasia (CIN) grade 2/3 or worse (CIN2/3+) detection.Results:The sensitivities and specificities of primary HPV testing for CIN2+ were:83.8%,88.1% for physiciancareHPV;72.1%,88.2% for self-careHPV;and 97.1%,86.0% for HC2.Physician-careHPV test-positive women with ⅥA triage had a sensitivity of 30.9% for CIN2+ versus 80.9% with cytology triage.Self-careHPV testpositive women with ⅥA triage was 26.5% versus 66.2% with cytology triage.The sensitivity of HC2 test-positive women with ⅥA triage was 38.2% versus 92.6% with cytology triage.The sensitivity ofphysician-careHPV testing for CIN2+ decreased from 83.8% at ≥1.0 RLU/CO to 72.1% at ≥10.00 RLU/CO,while the sensitivity of selfcareHPV testing decreased from 72.1% at ≥1.0 RLU/CO to 32.4% at ≥10.00 RLU/CO;similar trends were seen with age-stratification.Conclusions:ⅥA and cytology triage improved specificity for CIN2/3 than no triage.Sensitivity with ⅥAtriage was unsuitable for a mass-screening program.ⅥA provider training might improve this strategy.Cytology triage could be feasible where a high-quality cytology program exists.Triage of HPV test-positive women by increased test positivity cutoff adds another LRS triage option.
其他文献
期刊
【摘要】目的分析导致儿童急性中毒的相关因素,探讨其急救措施。方法随机选取我院2011年2月至2013年2月收治的68例急性中毒患儿,对患儿的临床资料进行分析,总结中毒因素和急救方法。结果食物中毒是儿童急性中毒的主要因素,占总数的45.6%,中毒患儿大多数1-4岁,67例经抢救治疗康复,1例CO中毒因时间过长抢救无效死亡。结论食物中毒是儿童急性中毒的主要原因,对于急性中毒患儿,应及时进行抢救,提高患
患男,67岁,以“发现双下肢皮疹3d”入院。2年前患脑梗塞,1月前遵中医嘱自制水蛭胶囊1g tid(水蛭研末0.25g/粒),既往无特殊过敏史。查体:肺(-),心脏(-),腹部(-),双下肢膝关节以下对称分布
【摘要】目的分析儿童哮喘发病的相关因素。方法对我院自2011年10月至2012年8月收治的50例哮喘患儿进行资料分析,选取同期我院进行过健康体检的患儿50例作为对照组,对发病的危险因素进行回归分析。结果过敏性鼻炎、母孕期妊高症、过敏史、湿疹史、上感次数、母孕期早孕反应和家族史为高危因素;其余宠物接触史、工厂、母亲化妆品、开花植物、潮湿、家庭收入、被动吸烟、母乳喂养、住房面积、蚊香和煤炉等危险因素。
[关键词]苯磺酸左旋氨氯地平;阿托伐他汀;高血压;颈动脉内膜中层厚度;血脂  中图分类号:R544.1文献标识码:B文章编号:1009_816X(2014)05_0431_02  doi:10.3969/j.issn.1009_816x.2014.05.29颈动脉内膜中层厚度(IMT)被证明是一种早期反映全身动脉粥样硬化的有效指标。因此,本研究旨在探讨苯磺酸左旋氨氯地平联合阿托伐他汀对高血压患者颈
Objective:This study was designed to explore the time trends in geographical variations of cervical cancer mortality in mainland China over the period 1973 to 2
目的 分析海南省2个城镇娱乐场所中,提供或可能提供性服务的女性从业人员,与不同性伴的性行为及其安全套的使用状况,揭示该人群在艾滋病传播中的桥梁作用,探索针对该人群的艾
【关键词】钴-60;三维适形治疗;剂量;误差  doi:10.3969/j.issn.1004-7484(s).2014.01.278文章编号:1004-7484(2014)-01-0238-01  钴-60远距离治疗机自1951年加拿大第一台建成以来,50多年间得到了迅速的发展和广泛的应用。虽然钴-60远距离治疗机与加速器相比,存在能量单一,半影大,半衰期短以及防护等问题,但具有经济、可靠、结构
亚历山大病(Alexander disease,AxD)是一种罕见的常染色体显性遗传性脑白质病,最先是由Alexander于1949年进行报道提出的[1] .影响该病的主要致病基因为胶质纤维酸性蛋白(GFA
阿托品是临床解救有机磷中毒的常用药。阿托品总剂量可因患者中毒程度而相差很大。我院 1998年6月~ 1999年 6月收治 8例重症有机磷中毒患者 ,阿托品用量 2 .8~ 5.2 g,现报道如