Evaluation of alternately combining HPV viral load and 16/18 genotyping in secondary screening algorithms

Correlation with HPV viral load and worsening cervical lesions had been reported, but its potential for triage after primary HPV screening has not been adequately explored, especially when combined with HPV-16/18 genotyping. To evaluate combinations of human papillomavirus (HPV) viral load and genot...

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Bibliographic Details
Published in:PloS one 2019-07, Vol.14 (7), p.e0220200-e0220200
Main Authors: Luo, Hongxue, Du, Hui, Belinson, Jerome L, Wu, Ruifang
Format: Article
Language:English
Subjects:
Adult
Algorithms
Antiretroviral drugs
Biology and Life Sciences
Biomarkers
Cancer
Cancer screening
Cellular biology
Cervical cancer
Cervical Intraepithelial Neoplasia - virology
Cervix dysplasia
Colposcopy
Cytology
Diagnosis
DNA, Viral - analysis
Feasibility Studies
Female
Genetic aspects
Genotyping
Genotyping Techniques
Gynecology
Health screening
Human papillomavirus
Human papillomavirus 16 - genetics
Human papillomavirus 16 - physiology
Human papillomavirus 18 - genetics
Human papillomavirus 18 - physiology
Humans
Ionization
Ions
Laboratories
Laser arrays
Lesions
Load distribution
Mass spectrometry
Mass spectroscopy
Medical screening
Medicine and Health Sciences
Middle Aged
Obstetrics
Oncology
Papillomavirus
Papillomavirus infections
Papillomavirus Infections - diagnosis
Physical Sciences
Research and Analysis Methods
Risk factors
Scientific imaging
Sensitivity
Sensitivity and Specificity
Spectroscopy
Strategy
Triage
Viral Load
Womens health
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Summary:Correlation with HPV viral load and worsening cervical lesions had been reported, but its potential for triage after primary HPV screening has not been adequately explored, especially when combined with HPV-16/18 genotyping. To evaluate combinations of human papillomavirus (HPV) viral load and genotyping for HPV-16/18 as secondary screening strategies. The Shenzhen Cervical Cancer Screening Trial Ⅱ (SHENCCAST Ⅱ) database was re-analyzed to explore new screening algorithms using the results of Hybrid Capture 2 (HC2), Mass Array Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass spectrometry System (MALDI-TOF-MS) and the ThinPrep cytologic test (TCT) obtained by endocervical sampling. Compared with the recommended screening strategy of genotyping HPV-16/18 plus reflex to cytology, using viral load (10 RLU/CO as threshold) plus reflex to cytology resulted in less cytology but had a significantly higher sensitivity for cervical intraepithelial neoplasia 2+ (CIN2+)/CIN3+ without considerable changes in specificity and referral rates. Both of the strategy of using viral load ≥10 RLU/CO as cut-point for immediate colposcopy followed by triage genotyping HPV-16/18 for the other positive (≥1
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0220200