자궁경부암 조기 선별검진에 있어서 병합검진의 임상적 비교평가

Abstract

Objective : Since the accuracy of Pap smear for cervical neoplasm has been questioned, a number of adjunctive tests have been developed. The purpose of this study was to evaluate which protocol is the most effective screening test among cervical cytology(ThinPrep?), HPV DNA test(Hybrid capture? II) and cervicography.Study design : This study was performed among 829 patients who visited the department of Obstetrics and Gynecology, Chosun university hospital from Jul, 2002 to Sep, 2005 for cervical cancer screening. And we chose 252 patients who were performed biopsy.252 patients who were engaged in this study simultaneously underwent cervical cytology(ThinPrep?), HPV DNA test(Hybrid capture? II), cervicography for cervical cancer screening and colposcopic-directed biopsy or biopsy on operation for diagnostic evaluation.Results : In detecting abnormal cervical lesions, the triple combined test(cervical cytology(ThinPrep?) + HPV DNA test(Hybrid capture? II) + cervicography) showed a sensitivity of 96.0%, while double combined test(cervical cytology(ThinPrep?) + cervicography) showed a sensitivity of 89.0%, other double combined test(cervical cytology(ThinPrep?) + HPV DNA test(Hybrid capture? II)) of 86.7%. Cervicography showed a specificity of 75.4%(highest among the single test), positive predictability of 89.8%(also highest).Conclusions : The sensitivity of cervical cytology(ThinPrep?) was markedly improved by combination with HPV DNA test(Hybrid capture? II) and cervicography. So the triple combined tests which improve high false negative rate of cervical cytology may be a new effective method as a cervical cancer screening test, if the effectiveness could be confirmed by mass screening study.