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Comparison of different strategies for the triage to colposcopy of women tested high-risk HPV positive on self-collected cervicovaginal samples.
Chatzistamatiou, Kimon; Tsertanidou, Athena; Moysiadis, Theodoros; Mouchtaropoulou, Evangelia; Pasentsis, Konstantinos; Skenderi, Alkmini; Stamatopoulos, Kostas; Agorastos, Theodoros.
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  • Chatzistamatiou K; 1(st) Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece. Electronic address: kimon.chatzistamatiou@gmail.com.
  • Tsertanidou A; 3(th) Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece.
  • Moysiadis T; Institute of Applied Biosciences, Centre for Research & Technology - Hellas, Thessaloniki, Greece; Department of Computer Science, School of Sciences and Engineering, University of Nicosia, 2417 Nicosia, Cyprus.
  • Mouchtaropoulou E; Institute of Applied Biosciences, Centre for Research & Technology - Hellas, Thessaloniki, Greece.
  • Pasentsis K; Institute of Applied Biosciences, Centre for Research & Technology - Hellas, Thessaloniki, Greece.
  • Skenderi A; Department of Cytology, Hippokratio General Hospital, Thessaloniki, Greece.
  • Stamatopoulos K; Institute of Applied Biosciences, Centre for Research & Technology - Hellas, Thessaloniki, Greece.
  • Agorastos T; Department of Gynecologic Oncology, St. Luke's Hospital, Thessaloniki, Greece.
Gynecol Oncol ; 162(3): 560-568, 2021 09.
Article en En | MEDLINE | ID: mdl-34210517
OBJECTIVE: To identify the optimal strategy for the triage of women who test high-risk (hr) HPV positive on self-collected cervicovaginal samples. METHODS: This is a diagnostic accuracy sub-analysis of the GRECOSELF study, which reported on HPV-DNA testing with self-sampling in Greece. More than 13,000 women, 25-60 years old, who resided in rural areas of Greece, provided a self-collected cervicovaginal sample. Samples were tested for HPV-DNA and HPV16/18 genotyping with the cobas® HPV test (Roche® Molecular Systems, Pleasanton, CA, USA). HrHPV positive women were referred for colposcopy. Prior to colposcopy a physician-collected sample was obtained for cytology. After colposcopy/biopsy, women were classified as having cervical disease or not, and treated accordingly. RESULTS: Out of 1070 hrHPV positive women, 773 were subjected to colposcopy. Seventeen triage strategies, combining HPV16/18 genotyping and cytology, were investigated. The strategy referring to colposcopy women positive for HPV16 regardless of the cytology report, and women positive for other hrHPVs, in case of a subsequent atypical squamous cells of undetermined significance or worse (ASCUS+) cytology report, presented optimal trade-off; sensitivity 96.36% [(95%CI: (91.41-100.0)], positive predictive value (PPV) 27.46% [95%CI: (21.16-33.76)], and number of colposcopies required to detect one case of Cervical Intraepithelial Neoplasia grade-2 or worse (CIN2+) 3.64. CONCLUSIONS: The optimal strategy for the triage to colposcopy of hrHPV positive women, detected with the cobas® HPV test on self-collected cervicovaginal samples, is referring all HPV16 positive women directly to colposcopy, and women positive for HPV18 or other hrHPVs only after an ASCUS or worse cytology report.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Manejo de Especímenes / Frotis Vaginal / Cuello del Útero / Colposcopía / Infecciones por Papillomavirus / Alphapapillomavirus Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Gynecol Oncol Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Manejo de Especímenes / Frotis Vaginal / Cuello del Útero / Colposcopía / Infecciones por Papillomavirus / Alphapapillomavirus Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: Gynecol Oncol Año: 2021 Tipo del documento: Article Pais de publicación: Estados Unidos