The Application of Liquid-Based Cytological Detection for P16, Cytologic Evaluation and High-Risk Human Papillomavirus Testing in Cervical Cancer Screening: A Clinical Evaluation

Int J Womens Health. 2022 Jul 28:14:965-973. doi: 10.2147/IJWH.S365236. eCollection 2022.

Abstract

Objective: The aim of this study was to clinically evaluate the application of liquid-based cytology P16, cytologic evaluation, and high-risk human papillomavirus (HR-HPV) testing in cervical cancer screening.

Methods: This study screened 900 women, who attended the outpatient clinic, according to the exclusion criteria of study participants. The study participants' screening results of liquid-based cytology P16, cytologic evaluation, and HR-HPV testing were analyzed. According to the pathological results of the biopsy, the efficacy of different screening strategies for the identification of high-grade lesions was evaluated.

Results: The positive rate of p16 expression increased with the severity of cervical lesions. P16 had the highest sensitivity and negative predictive value in identifying high-grade lesions (98.45% and 99.67%, respectively). Liquid-based Papanicolaou test (LBP), on the other hand, had the lowest sensitivity (85.27%) but the highest specificity (85.88%). HR-HPV's positive predictive value and accuracy rate were the lowest (32.77% and 70.03%, respectively). The difference was statistically significant (P < 0.05). Dual combinations of certain tests were set up for this study; P16+LBP, HPV+LBP, and P16+HPV had sensitivities of 98.45%, 96.90%, and 99.22%, and specificities of 80.29%, 63.42%, and 64.33%, respectively. The P16 screening rates of histological and liquid-based cytology approaches were 75.74%.

Conclusion: Compared with traditional LBP+HPV, the application of a test that solely screen for P16 or the combined screening method that involves the screening of P16 is more effective in identifying high-grade lesions.

Keywords: HR-HPV; biomarkers; liquid-based cytology; p16; screening of high-grade cervical lesions.