Clinical utility of p16/Ki67 dual‐stain cytology for detection of cervical intraepithelial neoplasia grade two or worse in women with a transformation zone type 3: A cross‐sectional study: A cross-sectional study
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| Titel: | Clinical utility of p16/Ki67 dual‐stain cytology for detection of cervical intraepithelial neoplasia grade two or worse in women with a transformation zone type 3: A cross‐sectional study: A cross-sectional study |
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| Autoren: | Line Winther Gustafson, Mette Tranberg, Pia Nørgaard Christensen, Rikke Brøndum, Nicolas Wentzensen, Megan A. Clarke, Berit Andersen, Lone Kjeld Petersen, Pinar Bor, Anne Hammer |
| Quelle: | BJOG Gustafson, L W, Nielsen, M T, Christensen, P, Brøndum, R, Wentzensen, N, Clarke, M, Andersen, B, Kjeld Petersen, L, Bor, I P & Hammer, A 2023, 'Clinical utility of p16/Ki67 dual-stain cytology for detection of cervical intraepithelial neoplasia grade two or worse in women with a transformation zone type : 3: A cross-sectional study', B J O G, vol. 130, no. 2, pp. 202-209. https://doi.org/10.1111/1471-0528.17248 |
| Verlagsinformationen: | Wiley, 2022. |
| Publikationsjahr: | 2022 |
| Schlagwörter: | Uterine Cervical Neoplasms, cervical intraepithelial neoplasia, RESEARCH ARTICLES, 03 medical and health sciences, 0302 clinical medicine, Humans, liquid-based cytology, human papillomavirus, Coloring Agents, Papillomaviridae, Cyclin-Dependent Kinase Inhibitor p16, Aged, Vaginal Smears, postmenopausal, colposcopy, Papillomavirus Infections, Middle Aged, Uterine Cervical Dysplasia, transformation zone type 3, 3. Good health, Cross-Sectional Studies, Ki-67 Antigen, Cyclin-Dependent Kinase Inhibitor p16/analysis, Colposcopy, Female, Uterine Cervical Dysplasia/pathology, large-loop excision of the transformation zone, p16/Ki67 dual-stain cytology, Ki-67 Antigen/analysis |
| Beschreibung: | ObjectiveTo evaluate the clinical utility of p16/Ki67 dual‐stain (DS) compared with cytology for detecting cervical intraepithelial lesion grade two or worse (CIN2+) in women with a transformation zone type 3 (TZ3).DesignCross‐sectional study.SettingColposcopy clinics in Central Denmark Region.PopulationWomen aged 45 years or older referred for colposcopy because of an abnormal screening test.MethodsAll women had a cervical sample collected for cytology and DS testing and underwent large‐loop excision of the transformation zone (LLETZ).Main outcome measureSensitivity, specificity and negative (NPV) and positive (PPV) predictive values of DS for CIN2+ detection were compared to those of cytology.ResultsOf 166 women eligible, 93 (56.0%) were included in the final analysis. Median age was 68 years (interquartile range [IQR] 63.4–70.5 years). Most women were postmenopausal (95.7%) and referred based on a positive human papillomavirus screening test (86.0%). Fifty‐two women (55.9%) were DS‐positive, 29 (55.8%) of whom had CIN2+ detected. Twenty‐seven (29.0%) women had atypical squamous cells of undetermined significance or worse (ASC‐US+), and CIN2+ was detected in 21 women (77.8%). DS had a higher sensitivity (96.7% versus 70.0% p = 0.021) and NPV (97.6% versus 86.4%, p = 0.018) compared with cytology for CIN2+ detection. In contrast, the specificity (63.5% versus 90.5% p p = 0.001) were lower for DS compared with cytology.ConclusionsDual stain may be a valuable risk marker to guide clinical management of women with a TZ3. The superior NPV of DS suggests that a diagnostic excision may safely be avoided in DS‐negative women. |
| Publikationsart: | Article Other literature type |
| Sprache: | English |
| ISSN: | 1471-0528 1470-0328 |
| DOI: | 10.1111/1471-0528.17248 |
| Zugangs-URL: | https://pubmed.ncbi.nlm.nih.gov/35686564 |
| Rights: | CC BY |
| Dokumentencode: | edsair.doi.dedup.....1ef6dde89c6b2cfd9a7e714d144b4b33 |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | ObjectiveTo evaluate the clinical utility of p16/Ki67 dual‐stain (DS) compared with cytology for detecting cervical intraepithelial lesion grade two or worse (CIN2+) in women with a transformation zone type 3 (TZ3).DesignCross‐sectional study.SettingColposcopy clinics in Central Denmark Region.PopulationWomen aged 45 years or older referred for colposcopy because of an abnormal screening test.MethodsAll women had a cervical sample collected for cytology and DS testing and underwent large‐loop excision of the transformation zone (LLETZ).Main outcome measureSensitivity, specificity and negative (NPV) and positive (PPV) predictive values of DS for CIN2+ detection were compared to those of cytology.ResultsOf 166 women eligible, 93 (56.0%) were included in the final analysis. Median age was 68 years (interquartile range [IQR] 63.4–70.5 years). Most women were postmenopausal (95.7%) and referred based on a positive human papillomavirus screening test (86.0%). Fifty‐two women (55.9%) were DS‐positive, 29 (55.8%) of whom had CIN2+ detected. Twenty‐seven (29.0%) women had atypical squamous cells of undetermined significance or worse (ASC‐US+), and CIN2+ was detected in 21 women (77.8%). DS had a higher sensitivity (96.7% versus 70.0% p = 0.021) and NPV (97.6% versus 86.4%, p = 0.018) compared with cytology for CIN2+ detection. In contrast, the specificity (63.5% versus 90.5% p p = 0.001) were lower for DS compared with cytology.ConclusionsDual stain may be a valuable risk marker to guide clinical management of women with a TZ3. The superior NPV of DS suggests that a diagnostic excision may safely be avoided in DS‐negative women. |
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| ISSN: | 14710528 14700328 |
| DOI: | 10.1111/1471-0528.17248 |