Shuo Zhao, Jie Gao, Wei Ma*
Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China
Objective: To investigate the diagnostic value of Aptima human papillomavirus (HPV) combined with thinprep cytology test (TCT) in screening high-grade cervical lesions.
Methods: A total of 1085 patients with suspected cervical lesions in Beijing Luhe Hospital, Capital Medical University from September 2020 to August 2021 were collected. All patients underwent Aptima HPV, TCT and cervical multipoint biopsy under colposcopy. Patients with positive Aptima HPV were further tested for Optima HPV16/18/45 genotype. Using histopathological results as the ‘gold standard, we analyzed and compared the diagnostic value of Aptima HPV and TCT screening alone or in combination in high-grade cervical lesions.
Results: The sensitivity and negative predictive value of Aptima HPV combined with TCT were higher than those of single Aptima HPV and TCT (98.83%vs96.21%vs38.48%; 95.12%vs91.95%vs71.37%), The specificity and accuracy were lower than that of Aptima HPV and TCT alone (10.51%vs21.7%vs70.89%;38.4%vs45.25%vs60.65%) (P <0.05). The positive rate of Aptima HPV and TCT elevated gradually with the increase of histopathological grade. The positive rate of Aptima HPV in histopathology diagnosed as HSIL or serious than HSIL group was significantly higher than that of TCT (96.21%vs38.48%, P<0.05). Among the different shunting methods, TCT+ combined with HPV16/18/45+ group had the highest detection rate of histopathology diagnosed as HSIL or serious than HSIL lesions (62.8%), and the OR value was 1.55 times higher than that of TCT+/other HPV+ group, 1.66 times higher than that of TCT+ group, and 1.73 times higher than that of HPV+group (95%CI:4.882-33.940, P <0.05). In all Aptima HPV positive groups, the highest detection rate of histopathology diagnosed as HSIL or serious than HSIL lesions was found in the HPV16/18/45+ group (43.6%), and the OR value was 1.33 times higher than that of the other HPV + groups (95% CI:3.407-23.468,P<0.05).
Conclusion: TCT combined with Aptima HPV can significantly improve the screening ability of high-grade cervical lesions, especially TCT combined with Aptima HPV16/18/45 genotype test has better risk prediction ability for histopathology diagnosed as HSIL or serious than HSIL lesions than any single or combined screening, which can be promoted as an opportunistic screening method for clinical cervical cancer.
Human papillomavirus E6/E7 mRNA, Aptima, thinprep cytology test, cervical cancer screening.