Abstract:
OBJECTIVE:To evaluate the effectiveness of five methods including the ThinPrep cytological test (TCT), liquid-based cytology, the human papillomavirus (HPV) test, detection of the TERC and C-MYC genes and visual inspection with acetic acid/Lugol's iodine (VIA/VILI) for opportunistic cervical cancer screening, and to explore whether genomic amplification of the human telomerase gene and C-MYC in liquid-based cytological specimens can be used as a method for opportunistic cervical cancer screening. METHODS:Data were collected prospectively from 1,010 consecutive patients who visited the gynecology clinic and agreed to participate in opportunistic cervical cancer screening at our institution from November 2010 to July 2011. The five methods mentioned above were used for the screening in all cases. The histopathological diagnosis served as the gold standard for the evaluation. A comparison between the five screening methods for the diagnosis of high-grade cervical intraepithelial neoplasia (CIN II and III) was performed for their sensitivity, specificity, false-positive rate, false-negative rate, accuracy rate, positive likelihood ratio and negative likelihood ratio. A comprehensive comparison of the different combination programs for screening was performed according to the analysis of the receiver operating characteristic (ROC) curve area. The accuracy of the five screening methods for the diagnosis of high-grade CIN (CIN II and III) was compared in the different age groups. A joint model for the diagnosis using different combinations of the five methods was developed according to the analysis by the SAS 8.0 software. The model was used to evaluate the accuracy of the different combination programs for the diagnosis of high-grade CIN, and the results were confirmed by the histopathological examination. RESULTS:The sensitivity and specificity of the single screen method (TCT, HPV test, detection of the TERC and C-MYC genes, and VIA/VILI method) for CIN II was 80.9, 70.2, 72.3, 76.6, and 72.3%, as well as 98.0, 95.1, 96.3, 96.3, and 90.4%, respectively. The sensitivity of the single screening method in four different age groups (25-34, 35-44, 45-54 and 55-66 years) was as follows: TCT, 64.3, 90.9 76.5, and 85.7%; HPV test, 78.6, 72.7, 60.0, and 71.4%; the TERC gene, 50.0, 90.9, 80.0, and 71.4%; the C-MYC gene, 50.0, 90.9, 80.0, and 100%; VIA/VILI, 85.7, 81.8, 66.7, and 42.9%. The specificity was: TCT, 98.9, 98.1, 98.8, and 95.2%; HPV test, 96.7, 95.1, 92.2, and 100%; the TERC gene, 95.0, 98.9, 94.0, and 95.2%; the C-MYC gene, 97.2, 97.3, 93.4, and 97.6%; VIA/VILI, 91.2, 90.5, 89.8, and 88.1%, respectively. In the joint model for the diagnosis using different combinations, we found Logit (P) = 5.757 - 4.055 × TCT - 3.724 × HPV. The sensitivity and specificity in the combination program with TCT (primary screening) and HPV testing (adjunct screening) were 78.7 and 99.5%, while in the combination with HPV (primary) and TCT (adjunct), they were 53.2 and 99.7%, respectively. However, in the cytology-HPV parallel test, they were 97.9 and 93.4%. The ROC analysis revealed that the cytology-HPV parallel test is superior to the combinations of either TCT (primary) and HPV (adjunct) or HPV (primary) and TCT (adjunct; AUCTCT-HPV parallel test = 0.956; AUCTCT/primaryHPV/adjunct = 0.764). CONCLUSIONS:Opportunistic cervical cancer screening is a practical approach to improve the efficiency of cervical cancer screening. Although the accuracy of TCT is the highest of the five screening methods for the diagnosis of high-grade CIN, it is still subject to sample acquisition and the practitioner's skill and experience. Since the efficacy of VIA/VILI may vary in all ages, it is not recommended for menopausal and perimenopausal women.
journal_name
Gynecol Obstet Investjournal_title
Gynecologic and obstetric investigationauthors
Gao K,Eurasian M,Zhang J,Wei Y,Zheng Q,Ye H,Li Ldoi
10.1159/000371760subject
Has Abstractpub_date
2015-01-01 00:00:00pages
153-63issue
3eissn
0378-7346issn
1423-002Xpii
000371760journal_volume
80pub_type
杂志文章abstract::Implantation of intrauterine devices (IUDs) is associated with an increased incidence of uterine infection, probably as a result of vaginal bacteria entering the uterus at the time of insertion. To reduce the incidence of IUD-related infections, the incorporation of antimicrobial agents into the tail of the device was...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000010256
更新日期:2000-01-01 00:00:00
abstract::The ovarian morphology in 149 patients with the clinical syndrome of polycystic ovaries (group I) is described. The ovaries from 10 age-matched women (group II) with no signs of ovarian disorder were investigated as a reference material. The number of cysts documented for group I was twice that of the reference group ...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000293771
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Dyslipidemia is commonly observed in polycystic ovary syndrome (PCOS) patients. Bezafibrate is a drug for dyslipidemia acting through peroxisome proliferator-activated receptors. We investigated the effects of bezafibrate for ovulation induction in patients with PCOS with dyslipidemia who were resistant to c...
journal_title:Gynecologic and obstetric investigation
pub_type: 临床试验,杂志文章
doi:10.1159/000316265
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:Assessment of the contraceptive effectiveness of pure estradiol pellets implanted annually under the skin, thus avoiding the 'first passage phenomenon' through the liver, using a modification of Emperaire and Greenblatt's method. STUDY DESIGN:228 women wishing birth control for 1 year or more were included....
journal_title:Gynecologic and obstetric investigation
pub_type: 临床试验,杂志文章
doi:10.1159/000082652
更新日期:2005-01-01 00:00:00
abstract::Abdominal pregnancy is a very rare and serious type of extrauterine gestation that accounts for approximately 0.003% of all ectopic pregnancies. Omental pregnancy, an extremely rare form of abdominal pregnancy, can be primary or secondary to a tubal pregnancy that aborts out of the fimbria and reimplants in the perito...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000070188
更新日期:2003-01-01 00:00:00
abstract::The crisis frequency of stress incontinence (SI) is known to be high among pregnant women. This preliminary study was performed to determine whether the diagnostic standard of the Q-tip test used in the diagnosis of SI in nonpregnant women is applicable to pregnant women. The Q-tip tests were performed regularly durin...
journal_title:Gynecologic and obstetric investigation
pub_type: 临床试验,杂志文章
doi:10.1159/000052900
更新日期:2001-01-01 00:00:00
abstract::We have previously described the identification of the human decidua-associated protein hDP200 as a rheumatoid factor [1]. Assuming that rheumatoid factor binds to Fc of immunoglobulins, the existence of high-molecular-weight complexes was studied in decidual extract, pooled uterine fluid from proliferative and early ...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000292272
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To determine the normal limits of menstrual fluid volume during reproductive life, quantified by direct measurement. METHODS:This was an observational, prospective clinical trial of healthy women aged 20-49 years old, with normal menstrual periods, recruited in a Natural Family Planning Unit. Women collected...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000496608
更新日期:2019-01-01 00:00:00
abstract:AIMS:To investigate the differences in insulin resistance between women with recurrent miscarriage and those with normal pregnancy. METHODS:Pregnant women with a history of recurrent miscarriage were included in the patient group (n = 97), while those with no history of abnormal pregnancy were included in the control ...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000325165
更新日期:2011-01-01 00:00:00
abstract:AIM:We investigated whether there is a correlation between morphological changes of the lower uterine segment after caesarean section (CS), visualized by means of either a transvaginal sonography (TVS) or a sonohysterography (SHG), and the frequency of abnormal uterine bleedings reported by the women. METHODS:By means...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000091497
更新日期:2006-01-01 00:00:00
abstract::Subcutaneous heparin and plasma infusion were successfully used during an induced abortion in a young woman with familial antithrombin-III deficiency and a history of severe thrombotic episodes. :Women with herditary antithrombin-3 deficiency are exposed to a considerable risk of thrombosis during periods of thrombog...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000299612
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND/AIMS:To determine whether genetic alterations in the CD9 gene are associated with female infertility in humans. METHODS:We sequenced the entire coding region of this gene in 86 Japanese women with unexplained infertility and further conducted a case-control study of six tagging single nucleotide polymorphis...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000262451
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND/AIMS:The Accreditation Council for Graduate Medical Education (ACGME) requires that all Ob/Gyn residents accomplish scholarly activity. We hypothesize resident productivity is poor. METHODS:This was a web-based two-survey study using SurveyMonkey®. Surveys queried both program directors and residents regard...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000348562
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To describe three-dimensional (3-D) sonographic features of hydrops fetalis. METHODS:A total of 6 cases with hydrops fetalis from 15 to 32 weeks of gestation were studied with transabdominal 3-D sonography (3.5 MHz). RESULTS:Before around 20 weeks of gestation, the skin becomes a transparent-like structure,...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000010167
更新日期:1999-01-01 00:00:00
abstract:AIM:To evaluate the value of serum fructosamine as a screening test for gestational diabetes mellitus (GDM). METHODS:849 pregnant women underwent the one-step 75 g oral glucose tolerance test (OGTT) for universal screening of GDM. The fasting serum fructosamine (cFruc) was assessed using the area under the receiver op...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000318705
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/AIMS:To assess whether patients prefer surgery or a pessary as treatment for pelvic organ prolapse (POP). METHODS:A structured interview was performed among treated and untreated women with POP. We conducted fictive scenarios of potential disadvantages of surgery and pessary use. Our main outcome was the wi...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000336634
更新日期:2012-01-01 00:00:00
abstract::We focus on the roles of decidual and cumulus oophorus T cells. It was suggested that Th1-type cytokines (IFN-gamma and TNF-beta), which promote allograft rejection, may compromise pregnancy, whereas the Th2-type cytokines (IL-4, IL-5, IL-10) inhibiting the Th1 responses promote allograft tolerance and therefore may i...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章,评审
doi:10.1159/000101738
更新日期:2007-01-01 00:00:00
abstract::25 singleton pregnancies were terminated by cesarean section between 28 and 33 weeks of gestation because of suspected growth retardation and abnormal unstressed cardiotocograms. Only infants with birth weights below the tenth centile were considered. 17 survived and were neurologically examined at 2.5-7 years of age....
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000299030
更新日期:1985-01-01 00:00:00
abstract::A suburethral sling procedure using a Mersilene mesh has been performed in 24 patients. Six patients had recurrent incontinence after an unsuccessful past operation. A postoperative follow-up was done for an average of 24 months. Twenty-three patients were free of symptoms, while only 1 patient had recurrent incontine...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000292521
更新日期:1994-01-01 00:00:00
abstract::In the present study we have measured the concentrations of interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) in preovulatory follicular fluid (FF) samples obtained from patients undergoing ovulation induction with human menopausal gonadotropin/human chorionic gonadotropin. In 13 of the 24 (54...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000294853
更新日期:1992-01-01 00:00:00
abstract:BACKGROUNDS:What is not clear as yet is not only the etiology, but also the management of osseous metaplasia. We describe an infertile patient with osseous metaplasia and subsequent pregnancy after treatment and review the literature from infertility perspective. METHOD:We presented a 30-year-old woman with 8 years of...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章,评审
doi:10.1159/000439529
更新日期:2015-01-01 00:00:00
abstract::Fetal atrial septal aneurysm (ASA) is uncommon and little is known regarding its prevalence and clinical significance. In this report we describe 2 cases of fetal ASA diagnosed by ultrasonography. They were referred for examination because of fetal tachyarrhythmia in 1 case, and polyhydramnios in the other. The first ...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章,评审
doi:10.1159/000292030
更新日期:1996-01-01 00:00:00
abstract::ABO blood group was analyzed in 70 patients with hydatidiform mole and 53 patients with malignant trophoblastic disease. 319 healthy pregnant women served as controls. The distribution of ABO blood groups in patients with hydatidiform mole did not deviate significantly from the distribution in the controls. There was ...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000298967
更新日期:1985-01-01 00:00:00
abstract::One-sided artificial hydrosalpinx was caused in mature New Zealand rabbits by proximal and distal ligature. After 2 weeks the average secretion accumulation was 2.1 ml, after 8 weeks 6.3 ml. A fold relief could no longer be detected after 8 weeks. The light-microscopical study of the epithelium showed signs of cell de...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000299469
更新日期:1982-01-01 00:00:00
abstract:BACKGROUND/AIMS:To test the hypothesis that obstetrical disseminated intravascular coagulopathy results from an excessive leakage of fetal material into the maternal circulation. METHODS:All peripartum hysterectomy cases for hemorrhage at two suburban Illinois hospitals over 10 years were included. Intravascular prese...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000332373
更新日期:2012-01-01 00:00:00
abstract::Alleviation of infertility on the one hand and development of improved methods of contraception on the other are global concerns to woman's health. The molecular signals that regulate implantation are of clinical relevance since understanding the nature of these signals may lead to strategies to correct implantation f...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章,评审
doi:10.1159/000076761
更新日期:2004-01-01 00:00:00
abstract::Penis and testicle amputation, vaginoplasty, and clitoroplasty are procedures that help male-to-female transsexuals to accept their body and to increase psychosocial well-being. We describe a successful correction of prolapse of the neovagina with abdominovaginal sacropexy in a male-to-female transsexual who had under...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000064559
更新日期:2002-01-01 00:00:00
abstract::The diagnosis of vulvo-vaginal complaints has always been enigmatic in obstetrics and gynecology. Patients with clear, pathognomonic symptoms end up with a proper diagnosis and treatment most of the time, but unfortunately we are now living in a world where women reach out to the Internet and readily get all informati...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000478982
更新日期:2017-01-01 00:00:00
abstract::Previous reports have supported an association between tobacco smoking and cervical neoplasia. Our observations show an association between smoking and a reduction of the numerical densities of Langerhans cells and of helper/inducer T lymphocytes in the squamous epithelia of the transformation zone of the uterine cerv...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000292372
更新日期:1995-01-01 00:00:00
abstract::The patterns of plasma melatonin, gonadotropins, sex steroids and prolactin were studied in anovulatory infertile females undergoing ovulation induction with hMG/hCG. Melatonin levels were found to fluctuate during the menstrual cycle of these subjects with a nadir at mid-cycle and peak occurring at the early follicul...
journal_title:Gynecologic and obstetric investigation
pub_type: 杂志文章
doi:10.1159/000009977
更新日期:1998-01-01 00:00:00