Risk assessment and triage strategy of cervical cancer primary screening on HPV integration status:5-year follow-up of a prospective cohort study  

作　　者：Xun Tian Danhui Weng Ye Chen Yi Wang Xiao Li Xin Wang Chen Cao Danni Gong Zhen Zeng Qiongyan Wu Xueqian Wang Peng Wu Lu Fan Qinghua Zhang Hui Wang Zheng Hu Xiaodong Cheng Ding Ma 

机构地区：[1]Department of Gynecological Oncology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China [2]National Clinical Research Center for Obstetrics and Gynecology,Cancer Biology Research Center(Key Laboratory of the Ministry of Education),Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China [3]Department of Obstetrics and Gynecology,Academician expert workstation,The Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China [4]Department of Gynecology,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,China [5]Biomedical Innovation Center,The Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou,China [6]Department of Obstetrics and Gynecology,The Affiliated Panyu Central Hospital of Guangzhou Medical University,Guangzhou,China [7]Department of Epidemiology and Biostatistics,School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China [8]Department of Gynecologic Oncology,Women’s Hospital,School of Medicine,Zhejiang University,Hangzhou,China [9]Department of Gynecology and Obstetrics,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China [10]Maternal and Child Health and Family Planning Service Center of Longyou County,Quzhou,China [11]Department of Gynecologic Oncology,Zhongnan Hospital of Wuhan University,Wuhan,China

出　　处：《Journal of the National Cancer Center》2024年第4期311-317,共7页癌症科学进展（英文）

基　　金：supported by the National Nature Science Foun-dation of China(grant numbers:82141106,81630060);the National Key Research and Development Program of China(grant number:2021YFC2701204);Key Technology R&D Program of Hubei(grant num-ber:2024BCB057);Panyu District Science and Technology Plan Project(grant number:2020-Z04-014);Guangzhou Health Science and Tech-nology Project(grant number:20221A011118).

摘　　要：Objective:We investigated the relation between man papillomavirus(HPV)integration status and the immediate risk of cervical intraepithelial neoplasia(CIN),as well as the triage strategy based on HPV integration test.Methods:4086 women aged 20 to 65 years in China were enrolled in 2015 for a prospective,population-based,clinical observational study to evaluate the triage performance of HPV integration.Cervical exfoliated cells were collected for HPV testing and cytologic test.If high-risk HPV was positive,HPV integration test was performed at baseline,2-year and 5-year follow-up.Results:At baseline,HPV integration was positively correlated with the severity of cervical pathology,ranging from 5.0%(15/301)in normal diagnosis,6.9%(4/58)in CIN1,31.0%(9/29)in CIN2,70%(14/20)in CIN3,and 100%(2/2)in cervical cancer(P<0.001).Compared with cytology,HPV integration exhibits comparable sensitivity and negative predictive value for the diagnosis of CIN3+,higher specificity(92.8%[90.2%-95.4%]vs.75.5%[71.2%-79.8%],P<0.001)and higher positive predictive value(36.4%[22.1%-50.6%]vs.15.2%[8.5%-21.8%],P<0.001).HPV integration testing strategy yielded a significantly lower colposcopy referral rate than cytology strategy(10.7%[44/410]vs.27.3%[112/410],P<0.001).The HPV integration-negative group exhibited the lowest immediate risk for CIN3+(1.6%)and accounted for the largest proportion of the total population(89.3%),when compared with the normal cytology group(risk,1.7%;proportion,72.7%).Conclusion:As a key molecular basis for the development of cervical cancer,HPV integration might be a promising triage strategy for HPV-positive patients.

关 键 词：Human papillomavirus Cervical cancer screening HPV integration COLPOSCOPY Cervical intraepithelial neoplasia 

分 类 号：R73[医药卫生—肿瘤]