نوع مقاله : مقاله پژوهشی

نویسندگان

1 دکتری تخصصی، استاد، انجمن متخصصین زنان و مامایی ایران، تهران، ایران

2 دکتری تخصصی، بخش زنان و زایمان، بیمارستان امام خمینی (ره)، دانشگاه علوم پزشکی تهران، تهران، ایران

3 دکتری تخصصی، استادیار، واحد تشخیص مولکولی، آزمایشگاه پاتوبیولوژی آرمین، تهران، ایران

4 دکتری تخصصی، استاد، بخش پاتولوژی، بیمارستان امام خمینی (ره)، دانشگاه علوم پزشکی تهران، تهران، ایران

چکیده

مقدمه: cytology testing در کاهش میزان بروز سرطان دهانه رحم و کاهش مرگ و میر موفق بوده است. همچنین آزمایش‌های مولکولی مانند HPV typing، Aptima test می‌تواند اثربخشی غربالگری برای این نوع بدخیمی را بهبود بخشد. بر آن شدیم تا در این مطالعه ارزش تشخیصی تست‌های cytology testing، High-risk HPV DNA typing و APTIMA را در مقایسه با نتیجه‌ بیوپسی سرویکس در تشخیص کنسر و نئوپلازی سرویکس بررسی نماییم.
روش‌ها: تمام بانوان بالای ۲۱ سال و زیر ۶۵ سالی که علائم بالینی داشتند یا جهت تست غربالگری یا علائم بالینی مراجعه کرده بودند وارد مطالعه شدند.   با استخراج نتایج تست‌هایcytology testing ، High-risk HPV DNA typing و APTIMA از پرونده بیماران sensitivity و specifity این تست‌ها را محاسبه کردیم.
یافته‌ها: cytology testing دارای حساسیت 59٪ برای CIN2+ و ویژگی 61٪ بود. برای CIN I، حساسیت و ویژگی cytology testing بالاتر بود (63٪ و 71٪). Typing High-risk HPV DNA برای CIN2+ بیشترین حساسیت (76٪) را داشت، اما ویژگی آن کم (66٪) بود. حساسیت و ویژگی آن برای CIN I 51٪ و 74٪،  بود. آزمون آپتیما دارای حساسیت 7.53٪ و ویژگی 87.5٪  برای CIN2+ بود که حساسیت کمتری نسبت به Typing High-risk HPV DNA داشت، اما دارای ویژگی بالاتر بود. حساسیت آزمون آپتیما برای CIN I بسیار پایین بود (22.2٪)، اما ویژگی آن بسیار بالا بود (87.5٪).
نتیجه ­گیری: در این مطالعه نشان داده شد که High-risk HPV DNA typing بیشترین حساسیت (۷۵.۹٪) و APTIMA Test بیشترین ویژگی (۸۷.۵٪) را در پیشگویی CIN2+ در بین این سه تست دارد.

کلیدواژه‌ها

عنوان مقاله [English]

Diagnostic Value of Cytology Testing, High-risk HPV DNA Typing and Aptima HPV Assay based on Cervical Biopsy for Cervical Cancer and Neoplasia Diagnosis

نویسندگان [English]

  • Azamsadat Mousavi 1
  • Yasaman Farbod 2
  • Ali Pouryasin 3
  • Narges Izadi Mood 4

1 Ph.D., Professor, National Iranian Association of Gynecologists and obstetricians (Naigo), Tehran, Iran

2 Ph.D., Obstetrics and Gynecology ward, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Ph.D., Assistant Professor, Department of Molecular Diagnosis, Armin Pathobiology Laboratory, Tehran, Iran

4 Ph.D., Professor, Pathology ward, Imam Khomeini Hospital, Tehan University of Medical Sciences, Tehran, Iran

چکیده [English]

Introduction: Cytology testing has been successful in reducing the incidence of cervical cancer and mortality. Molecular testing like HPV typing and Aptima test can improve screening effectiveness. We compared the diagnostic value of cytology testing, High-risk (HR) HPV DNA typing, and APTIMA tests based on the results of the cervical biopsy in the diagnosis of cervical cancer and neoplasia in patients referred to Imam Khomeini Hospital.
Methods: One hundred fifty women between 21 and 56 years old who referred to having clinical symptoms or conducting screening tests enrolled in the study. Sensitivity, specificity, positive and negative predictive values, and accuracy for cervical involvement were calculated for cytology, High-risk HPV testing, and APTIMA tests separately.
Results: The most abundant genotype found was HPV 16. cytology testing had a sensitivity of 59% for CIN 2+ and a specificity of 61% for CIN 2+. For CIN I, the sensitivity and specificity of cytology testing were higher (63% and 71%, respectively). High-risk HPV typing had the highest sensitivity (76%) for CIN 2+, but its specificity was low (66%). Its sensitivity was 51% for CIN I with a specificity of 74%. APTIMA tests had a sensitivity of 53.7% and a specificity of 87.5% for CIN2 +, which was less sensitive to High-risk HPV typing but was more specific. The APTIMA test sensitivity for CIN I was very low (22.2%), but its specificity was high (87.5%).
Conclusion: High-risk HPV typing showed the highest sensitivity (75.9%) and APTIMA tests had the highest specificity (87.5%) in predicting CIN 2+.

کلیدواژه‌ها [English]

  • Cervical Cancer
  • Cervical intraepithelial neoplasia
  • Cytology testing
  • HPV typing
  • Aptima test
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