Issue
The clinical research of Thinprep Cytology Test (TCT) combined with HPV-DNA detection in screening cervical cancer
Corresponding Author(s) : J. Fang
Cellular and Molecular Biology,
Vol. 63 No. 2: Issue 2
Abstract
Our objective is to explore the clinical value of thinprep cytologic test (TCT) combined with HPV-DNA detection in screening cervical cancer. 420 cervical cancer patients admitted in our hospital between April, 2011-April, 2014 were selected. All patients received TCT and HPV-DNA detection, and cervical tissue biopsy was used to confirm the diagnosis. TCT screening results showed that there were 175 patients were >ASCUS and the positive rate was 41.7%, histopathological screening showed that there were 199 patients were ≥cervical intraepithelial neoplasia (CIN) I and the positive rate was 47.4%. HPV-DNA detection showed 180 patients were positive which was 42.9%, and the positive rate of HPV-DNA detection was increased as the disease severity increased. The sensitivity of TCT combined with HPV-DNA detection was higher than single TCT or HPV-DNA, however the specificity was relatively low, and the positive predictive value and negative predictive value were higher which were similar to pathological results. TCT combined with HPV-DNA detection has high sensitivity and accuracy in screening cervical cancer, which is worthy of clinical application.
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- Pengpid S, Peltzer K. Attitudes and practice of cervical cancer screening among female university students from 25 low, middle income and emerging economy countries. Asian Pac J Cancer Prev. 2014;15:7235-9.
- Wang HH, Wu SY. HPV vaccine knowledge and perceived risk of cervical cancer among female college students in Taiwan. Asian Pac J Cancer Prev. 2013;14:7371-4.
- Coskun S, Can H, Turan S. Knowledge about cervical cancer risk factors and pap smear testing behavior among female primary health care workers: a study from south Turkey. Asian Pac J Cancer Prev. 2013;14:6389-92.
- Paengchit K, Kietpeerakool C, Lalitwongsa S. Prevalence and genotype distribution of HPV among women attending a cervical cancer screening mobile unit in Lampang, Thailand. Asian Pac J Cancer Prev. 2014;15:6151-4.
- Petry KU. HPV and cervical cancer. Scand J Clin Lab Invest Suppl. 2014;244:59-62.
- Agorastos T, Chatzistamatiou K, Zafrakas M, Siamanta V, Katsamagkas T, Constantinidis TC, et al. Epidemiology of HPV infection and current status of cervical cancer prevention in Greece: final results of the LYSISTRATA cross-sectional study. Eur J Cancer Prev. 2014;23:425-31.
- Hyacinth HI, Adekeye OA, Ibeh JN, Osoba T. Cervical cancer and pap smear awareness and utilization of pap smear test among Federal civil servants in North Central Nigeria. PLoS One. 2012;7:e46583.
- Onwere S, Okoro O, Chigbu B, Onwere A. Knowledge and practice of cervical cancer screening using Pap smear among women attending antenatal clinic at Aba, south-eastern Nigeria. Niger J Clin Pract. 2009;12:341-2.
- Baseman JG, Kulasingam SL, Harris TG, Hughes JP, Kiviat NB, Mao C, et al. Evaluation of primary cervical cancer screening with an oncogenic human papillomavirus DNA test and cervical cytologic findings among women who attended family planning clinics in the United States. Am J Obstet Gynecol. 2008;199:26.e1-8.
- Siriaunkgul S, Settakorn J, Sukpan K, Srisomboon J, Suprasert P, Kasatpibal N, et al. Population-based cervical cancer screening using high-risk HPV DNA test and liquid-based cytology in northern Thailand. Asian Pac J Cancer Prev. 2014;15:6837-42.
- Noventa M, Ancona E, Cosmi E, Saccardi C, Litta P, D'Antona D, et al. Usefulness, methods and rationale of lymph nodes HPV-DNA investigation in estimating risk of early stage cervical cancer recurrence: a systematic literature review. Clin Exp Metastasis. 2014;31:853-67.
- Zappacosta R, Caraceni D, Ciccocioppo L, Rotondo T, Capanna S, Gatta DM, et al. Implementing specificity of HPV-DNA primary screening in a successful organised cervical cancer prevention programme. Gynecol Oncol. 2013;128:427-32.
- Zhao FH, Lewkowitz AK, Chen F, Lin MJ, Hu SY, Zhang X, et al. Pooled analysis of a self-sampling HPV DNA Test as a cervical cancer primary screening method. J Natl Cancer Inst. 2012;104:178-88.
- Kantathavorn N, Kietpeerakool C, Suprasert P, Srisomboon J, Khunamornpong S, Nimmanhaeminda K, et al. Clinical relevance of atypical squamous cells of undetermined significance by the 2001 bethesda system: experience from a cervical cancer high incidence region. Asian Pac J Cancer Prev. 2008;9:785-8.
- The 1988 Bethesda System for reporting cervical/vaginal cytological diagnoses. National Cancer Institute Workshop. JAMA. 1989;262:931-4.
- Navarro C, Fonseca AJ, Sibajev A, Souza CI, Araújo DS, Teles DA, et al. Cervical cancer screening coverage in a high-incidence region. Rev Saude Publica. 2015;49:17.
- Halaska M, Robova H, Pluta M, Rob L. The role of trachelectomy in cervical cancer. Ecancermedicalscience. 2015;9:506.
- Gul S, Murad S, Javed A. Prevalence of High risk Human Papillomavirus in cervical dysplasia and cancer samples from twin cities in Pakistan. Int J Infect Dis. 2015;34:14-9.
- Obel J, Souares Y, Hoy D, Baravilala W, Garland SM, Kjaer SK, et al. A systematic review of cervical cancer incidence and mortality in the Pacific Region. Asian Pac J Cancer Prev. 2014;15:9433-7.
- Vicus D, Sutradhar R, Lu Y, Elit L, Kupets R, Paszat L, et al. The association between cervical cancer screening and mortality from cervical cancer: a population based case-control study. Gynecol Oncol. 2014;133:167-71.
- Aminisani N, Armstrong BK, Egger S, Canfell K. Impact of organised cervical screening on cervical cancer incidence and mortality in migrant women in Australia. BMC Cancer. 2012;12:491.
- Zhang D, Li J, Ge H, Ju X, Chen X, Tang J, et al. Surgical and pathological outcomes of abdominal radical trachelectomy versus hysterectomy for early-stage cervical cancer. Int J Gynecol Cancer. 2014;24:1312-8.
- Yamauchi M, Fukuda T, Wada T, Kawanishi M, Imai K, Hashiguchi Y , et al. Comparison of outcomes between squamous cell carcinoma and adenocarcinoma in patients with surgically treated stage I-II cervical cancer. Mol Clin Oncol. 2014;2:518-524.
- Xia X, Xu H, Wang Z, Liu R, Hu T, Li S. Analysis of Prognostic Factors Affecting the Outcome of Stage IB-IIB Cervical Cancer Treated by Radical Hysterectomy and Pelvic Lymphadenectomy. Am J Clin Oncol. 2016;39:604-8.
- Fanfani F, Landoni F, Gagliardi ML, Fagotti A, Preti E, Moruzzi MC, et al. Sexual and Reproductive Outcomes in Early Stage Cervical Cancer Patients after Excisional Cone as a Fertility-sparing Surgery: An Italian Experience. J Reprod Infertil. 2014;15:29-34.
- Mayor S. Multiple biopsies improve cervical cancer detection in colposcopy. BMJ. 2015;350:h55.
- Ghosh I, Mittal S, Banerjee D, Singh P, Dasgupta S, Chatterjee S, et al. Study of accuracy of colposcopy in VIA and HPV detection-based cervical cancer screening program. Aust N Z J Obstet Gynaecol. 2014;54:570-5.
- Branković I, Verdonk P, Klinge I. Applying a gender lens on human papillomavirus infection: cervical cancer screening, HPV DNA testing, and HPV vaccination. Int J Equity Health. 2013;12:14.
- Kjí¦r SK, Munk C, Junge J, Iftner T. Carcinogenic HPV prevalence and age-specific type distribution in 40,382 women with normal cervical cytology, ASCUS/LSIL, HSIL, or cervical cancer: what is the potential for prevention? Cancer Causes Control. 2014;25:179-89.
- Wright TC Jr. HPV DNA testing for cervical cancer screening. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006;95:S239-46.
- Schiffman M, Herrero R, Hildesheim A, Sherman ME, Bratti M, Wacholder S, et al. HPV DNA testing in cervical cancer screening: results from women in a high-risk province of Costa Rica. JAMA. 2000;283:87-93.
- Origoni M, Cristoforoni P, Costa S, Mariani L, Scirpa P, Lorincz A, et al. HPV-DNA testing for cervical cancer precursors: from evidence to clinical practice. Ecancermedicalscience. 2012;6:258.
- Ancuţa E, Buţureanu S, Zugun-Eloae F, Anton CR, Ancuţa C, Diţescu D, et al. Potential value of in situ cellular immune response in HPV subtype 16 and 18 positive cervical cancer. Rom J Morphol Embryol. 2014;55:817-22.
- Ludwin A, Ludwin I, Pityński K, Jach R, Banaś T, Stangel-Wojcikiewicz K, et al. Prevalence of HPV-DNA in Pap smears containing ASC and AGC performed within Population Programme of Prophylaxis and Early Detection of Early Cervical Cancer. Przegl Lek. 2012;69:1189-93.
- Bhatla N, Moda N. The clinical utility of HPV DNA testing in cervical cancer screening strategies. Indian J Med Res. 2009;130:261-5.
- Knoepp SM, Kuebler DL, Wilbur DC. Resolution of equivocal results with the Hybrid Capture II high-risk HPV DNA test: a cytologic/histologic review of 191 cases. Diagn Mol Pathol. 2007;16:125-9.
- Lin CT, Tseng CJ, Lai CH, Hsueh S, Huang HJ, Law KS. High-risk HPV DNA detection by Hybrid Capture II. An adjunctive test for mildly abnormal cytologic smears in women > or = 50 years of age. J Reprod Med. 2000;45:345-50.
References
Pengpid S, Peltzer K. Attitudes and practice of cervical cancer screening among female university students from 25 low, middle income and emerging economy countries. Asian Pac J Cancer Prev. 2014;15:7235-9.
Wang HH, Wu SY. HPV vaccine knowledge and perceived risk of cervical cancer among female college students in Taiwan. Asian Pac J Cancer Prev. 2013;14:7371-4.
Coskun S, Can H, Turan S. Knowledge about cervical cancer risk factors and pap smear testing behavior among female primary health care workers: a study from south Turkey. Asian Pac J Cancer Prev. 2013;14:6389-92.
Paengchit K, Kietpeerakool C, Lalitwongsa S. Prevalence and genotype distribution of HPV among women attending a cervical cancer screening mobile unit in Lampang, Thailand. Asian Pac J Cancer Prev. 2014;15:6151-4.
Petry KU. HPV and cervical cancer. Scand J Clin Lab Invest Suppl. 2014;244:59-62.
Agorastos T, Chatzistamatiou K, Zafrakas M, Siamanta V, Katsamagkas T, Constantinidis TC, et al. Epidemiology of HPV infection and current status of cervical cancer prevention in Greece: final results of the LYSISTRATA cross-sectional study. Eur J Cancer Prev. 2014;23:425-31.
Hyacinth HI, Adekeye OA, Ibeh JN, Osoba T. Cervical cancer and pap smear awareness and utilization of pap smear test among Federal civil servants in North Central Nigeria. PLoS One. 2012;7:e46583.
Onwere S, Okoro O, Chigbu B, Onwere A. Knowledge and practice of cervical cancer screening using Pap smear among women attending antenatal clinic at Aba, south-eastern Nigeria. Niger J Clin Pract. 2009;12:341-2.
Baseman JG, Kulasingam SL, Harris TG, Hughes JP, Kiviat NB, Mao C, et al. Evaluation of primary cervical cancer screening with an oncogenic human papillomavirus DNA test and cervical cytologic findings among women who attended family planning clinics in the United States. Am J Obstet Gynecol. 2008;199:26.e1-8.
Siriaunkgul S, Settakorn J, Sukpan K, Srisomboon J, Suprasert P, Kasatpibal N, et al. Population-based cervical cancer screening using high-risk HPV DNA test and liquid-based cytology in northern Thailand. Asian Pac J Cancer Prev. 2014;15:6837-42.
Noventa M, Ancona E, Cosmi E, Saccardi C, Litta P, D'Antona D, et al. Usefulness, methods and rationale of lymph nodes HPV-DNA investigation in estimating risk of early stage cervical cancer recurrence: a systematic literature review. Clin Exp Metastasis. 2014;31:853-67.
Zappacosta R, Caraceni D, Ciccocioppo L, Rotondo T, Capanna S, Gatta DM, et al. Implementing specificity of HPV-DNA primary screening in a successful organised cervical cancer prevention programme. Gynecol Oncol. 2013;128:427-32.
Zhao FH, Lewkowitz AK, Chen F, Lin MJ, Hu SY, Zhang X, et al. Pooled analysis of a self-sampling HPV DNA Test as a cervical cancer primary screening method. J Natl Cancer Inst. 2012;104:178-88.
Kantathavorn N, Kietpeerakool C, Suprasert P, Srisomboon J, Khunamornpong S, Nimmanhaeminda K, et al. Clinical relevance of atypical squamous cells of undetermined significance by the 2001 bethesda system: experience from a cervical cancer high incidence region. Asian Pac J Cancer Prev. 2008;9:785-8.
The 1988 Bethesda System for reporting cervical/vaginal cytological diagnoses. National Cancer Institute Workshop. JAMA. 1989;262:931-4.
Navarro C, Fonseca AJ, Sibajev A, Souza CI, Araújo DS, Teles DA, et al. Cervical cancer screening coverage in a high-incidence region. Rev Saude Publica. 2015;49:17.
Halaska M, Robova H, Pluta M, Rob L. The role of trachelectomy in cervical cancer. Ecancermedicalscience. 2015;9:506.
Gul S, Murad S, Javed A. Prevalence of High risk Human Papillomavirus in cervical dysplasia and cancer samples from twin cities in Pakistan. Int J Infect Dis. 2015;34:14-9.
Obel J, Souares Y, Hoy D, Baravilala W, Garland SM, Kjaer SK, et al. A systematic review of cervical cancer incidence and mortality in the Pacific Region. Asian Pac J Cancer Prev. 2014;15:9433-7.
Vicus D, Sutradhar R, Lu Y, Elit L, Kupets R, Paszat L, et al. The association between cervical cancer screening and mortality from cervical cancer: a population based case-control study. Gynecol Oncol. 2014;133:167-71.
Aminisani N, Armstrong BK, Egger S, Canfell K. Impact of organised cervical screening on cervical cancer incidence and mortality in migrant women in Australia. BMC Cancer. 2012;12:491.
Zhang D, Li J, Ge H, Ju X, Chen X, Tang J, et al. Surgical and pathological outcomes of abdominal radical trachelectomy versus hysterectomy for early-stage cervical cancer. Int J Gynecol Cancer. 2014;24:1312-8.
Yamauchi M, Fukuda T, Wada T, Kawanishi M, Imai K, Hashiguchi Y , et al. Comparison of outcomes between squamous cell carcinoma and adenocarcinoma in patients with surgically treated stage I-II cervical cancer. Mol Clin Oncol. 2014;2:518-524.
Xia X, Xu H, Wang Z, Liu R, Hu T, Li S. Analysis of Prognostic Factors Affecting the Outcome of Stage IB-IIB Cervical Cancer Treated by Radical Hysterectomy and Pelvic Lymphadenectomy. Am J Clin Oncol. 2016;39:604-8.
Fanfani F, Landoni F, Gagliardi ML, Fagotti A, Preti E, Moruzzi MC, et al. Sexual and Reproductive Outcomes in Early Stage Cervical Cancer Patients after Excisional Cone as a Fertility-sparing Surgery: An Italian Experience. J Reprod Infertil. 2014;15:29-34.
Mayor S. Multiple biopsies improve cervical cancer detection in colposcopy. BMJ. 2015;350:h55.
Ghosh I, Mittal S, Banerjee D, Singh P, Dasgupta S, Chatterjee S, et al. Study of accuracy of colposcopy in VIA and HPV detection-based cervical cancer screening program. Aust N Z J Obstet Gynaecol. 2014;54:570-5.
Branković I, Verdonk P, Klinge I. Applying a gender lens on human papillomavirus infection: cervical cancer screening, HPV DNA testing, and HPV vaccination. Int J Equity Health. 2013;12:14.
Kjí¦r SK, Munk C, Junge J, Iftner T. Carcinogenic HPV prevalence and age-specific type distribution in 40,382 women with normal cervical cytology, ASCUS/LSIL, HSIL, or cervical cancer: what is the potential for prevention? Cancer Causes Control. 2014;25:179-89.
Wright TC Jr. HPV DNA testing for cervical cancer screening. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet. 2006;95:S239-46.
Schiffman M, Herrero R, Hildesheim A, Sherman ME, Bratti M, Wacholder S, et al. HPV DNA testing in cervical cancer screening: results from women in a high-risk province of Costa Rica. JAMA. 2000;283:87-93.
Origoni M, Cristoforoni P, Costa S, Mariani L, Scirpa P, Lorincz A, et al. HPV-DNA testing for cervical cancer precursors: from evidence to clinical practice. Ecancermedicalscience. 2012;6:258.
Ancuţa E, Buţureanu S, Zugun-Eloae F, Anton CR, Ancuţa C, Diţescu D, et al. Potential value of in situ cellular immune response in HPV subtype 16 and 18 positive cervical cancer. Rom J Morphol Embryol. 2014;55:817-22.
Ludwin A, Ludwin I, Pityński K, Jach R, Banaś T, Stangel-Wojcikiewicz K, et al. Prevalence of HPV-DNA in Pap smears containing ASC and AGC performed within Population Programme of Prophylaxis and Early Detection of Early Cervical Cancer. Przegl Lek. 2012;69:1189-93.
Bhatla N, Moda N. The clinical utility of HPV DNA testing in cervical cancer screening strategies. Indian J Med Res. 2009;130:261-5.
Knoepp SM, Kuebler DL, Wilbur DC. Resolution of equivocal results with the Hybrid Capture II high-risk HPV DNA test: a cytologic/histologic review of 191 cases. Diagn Mol Pathol. 2007;16:125-9.
Lin CT, Tseng CJ, Lai CH, Hsueh S, Huang HJ, Law KS. High-risk HPV DNA detection by Hybrid Capture II. An adjunctive test for mildly abnormal cytologic smears in women > or = 50 years of age. J Reprod Med. 2000;45:345-50.