Dual staining for p16/Ki67 is a more specific test than cytology for triage of HPV-positive women.
Globally, cervical cancer (CC) screening is moving from cytology-based to HPV screening or a combination of both (co-testing). Most HPV-positive women clear the virus and do not develop relevant disease. Additional triage approaches are needed to reduce unnecessary colposcopy referrals. The p16/Ki67...
| Publicado en: | Virchows Archiv: European Journal of Pathology Vol. 473; no. 5; pp. 599 - 607 |
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| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Nov2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=132699433&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 132699433 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09456317 O1Z jtl: Virchows Archiv: European Journal of Pathology issn: 09456317 maglogo: N pubinfo: dt: Nov2018 vid: 473 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 132699433 132699433 NLM30094492 10.1007/s00428-018-2432-z NLM30094492 132699433 ppf: 599 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Dual staining for p16/Ki67 is a more specific test than cytology for triage of HPV-positive women. aug: au: Areán-Cuns, Carolina Mercado-Gutiérrez, Maria Paniello-Alastruey, Irene Mallor-Giménez, Fermín Córdoba-Iturriagagoitia, Alicia Lozano-Escario, Maria Santamaria-Martínez, Mercedes affil: Department of Pathology, Complejo Hospitalario de Navarra, Calle Irunlarrea 3, Pabellón F, Servicio de Anatomía Patológica, 31008, Pamplona, Spain sug: subj: Proteins Metabolism Triage Methods Tumor Markers, Biological Metabolism Papillomavirus Infections Complications Cervix Neoplasms Diagnosis Carcinoma, Squamous Cell Diagnosis Middle Age Adolescence Carcinoma, Squamous Cell Aged Adult Carcinoma, Squamous Cell Metabolism Aged, 80 and Over Prospective Studies Young Adult Sensitivity and Specificity Cytodiagnosis Cervix Neoplasms Female Cervix Neoplasms Metabolism Middle Aged: 45-64 years Adolescent: 13-18 years Aged: 65+ years Adult: 19-44 years Aged, 80 & over Female ab: Globally, cervical cancer (CC) screening is moving from cytology-based to HPV screening or a combination of both (co-testing). Most HPV-positive women clear the virus and do not develop relevant disease. Additional triage approaches are needed to reduce unnecessary colposcopy referrals. The p16/Ki67 dual stain cytology test (DSCT) is one of the most promising, but it has not (yet) been included as a recommendation in European guidelines. Previous studies in Spain on this issue are lacking. We studied the performance of p16/Ki67 DSCT for the triage of HPV-positive women in Navarra to detect precursor lesions (PLs) and CC compared to cytology only. We selected 1865 HPV-positive women with p16/Ki67 DSCT results and 304 women with an available biopsy result. Sensitivity, specificity and predictive values of the p16/Ki67 DSCT to detect underlying PLs and CC compared to cytology were calculated, using the biopsy as the gold standard. Cytology and p16/Ki67 DSCT showed similar sensitivity (99.0% vs. 98.0%), but cytology had significantly lower specificity (6.9 vs. 39.1%). Of the CIN2+/HPV+ women, triage using cytology only would have resulted in 40.2% true PLs and CC, while using p16/Ki67 DSCT this was 98.0% qualifying the women for colposcopy referral. Our results show that p16/Ki67 DSCT detects more than twice as many true PLs and CC than cytology only in this population. Thus, this test can be considered as an important additional tool in HPV testing-based screening strategies, to avoid unnecessary colposcopy referrals and to reduce health care costs. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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