An efficient method that combines the ThinPrep cytologic test with E6/E7 mRNA testing for cervical cancer screening
Received 11 December 2018
Accepted for publication 23 April 2019
Published 24 May 2019 Volume 2019:11 Pages 4773—4780
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Dr Rituraj Purohit
Dan Pan,1,* Chan-Qiong Zhang,1,* Qi-Lian Liang,2 Xiao-Cui Hong2
1Department of Pathology, the Third Clinical Institute Affiliated to Wenzhou Medical University, Wenzhou People’s Hospital, Wenzhou, Zhejiang, People’s Republic of China; 2Oncology Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People’s Republic of China
*These authors contributed equally to this work
Background: Cervical cancer is strongly associated with persistent human papillomavirus (HPV) infections. The ThinPrep cytologic test (TCT), HPV DNA detection, and E6/E7 mRNA testing are widely used to screen for cervical abnormalities.
Purpose: This study aimed to find a suitable method for cervical cancer diagnosis (but not for cervical cancer distant metastasis), especially among women whose TCT results are atypical squamous cells of undetermined significance (ASCUS) or worse (including ASCUS).
Patients and methods: A total of 301 samples from Wenzhou People’s Hospital from June 2014 to September 2017 were collected, we conducted comparative analysis of the diagnostic performance of several conventional screening methods both individually and in combination.
Results: We compared the sensitivity, specificity, positive predictive value, negative predictive value, and Youden index retrospectively estimated not only by single TCT, HPV DNA detection, or E6/E7 mRNA testing but also by combination methods, such as TCT+HPV DNA, TCT+E6/E7 mRNA, or TCT+HPV DNA+E6/E7 mRNA. Screening under TCT+E6/E7mRNA was confirmed with relatively higher sensitivity of 76.1% (95% CI: 0.659–0.841), specificity of 74.6% (95% CI: 0.681–0.803), and the highest Youden index of 0.507.
Conclusion: The joint screening methods showed relatively reliable specificity and sensitivity for cervical disease screening, and detection by TCT+E6/E7 mRNA has the potential to be a widely used clinical method for cervical cancer screening.
Keywords: ThinPrep cytologic test, human papillomavirus DNA, E6/E7 mRNA, cervical cancer
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