Comparing the performance of six human papillomavirus tests in a screening population
Menée en Angleterre auprès de 6 000 femmes participant à un test de dépistage du cancer du col de l'utérus (âge : entre 20 et 66 ans), cette étude compare la sensibilité et la spécificité de six tests de recherche de l'ADN ou de l'ARN du papillomavirus humain pour détecter précocement des lésions cervicales précancéreuses ou cancéreuses
Background : Several new assays have been developed for high-risk HPV testing of cervical samples; we compare six HPV tests in a screening population.
Methods : Residual material from liquid-based PreservCyt samples was assayed. Four tests (Hybrid Capture 2, Cobas, Abbott and Becton-Dickinson (BD)) measured HPV DNA while two used RNA (APTIMA and NorChip).
Results : Positivity rates ranged from 13.4 to 16.3% for the DNA-based tests with a significantly lower positivity rate for the Abbott assay. The Gen-Probe APTIMA assay was positive in 10.3% of women, which was significantly lower than all the DNA tests; the NorChip PreTect HPV-Proofer test was much lower at 5.2%. 40 CIN2+ cases were identified, of which 19 were CIN3+. All CIN3+ cases were HPV positive by all tests except for one, which was negative by the Abbott assay and five which were negative by the NorChip test.
Conclusion : All HPV tests except NorChip showed high sensitivity for high-grade lesions positive by cytology, suggesting co-testing is unnecessary when using HPV tests. Positivity rates in cytology-negative specimens were similar for the DNA-based tests, but lower for the APTIMA test suggesting this maintains the high sensitivity of DNA tests, but with better specificity.
British Journal of Cancer , article en libre accès, 2012