Outcomes of prior cervical cytology and HR-HPV testing in women subsequently diagnosed with CIN1, CIN2/3, and invasive cervical cancer: a 4-year routine clinical experience after implementation of systematic training and quality control programs

Abstract

Background: In 2013, Jinan KingMed Diagnostics (JKD) first established a systematic cervical cytology training and quality control (QC) program in Shandong Province, China. We compared the efficacy of high-risk human papillomavirus (HR-HPV) detection, cytology, and their combination in routine clinical practice after the implementation of the training and QC program to identify the optimal first-line screening method in this region. Methods: The data of patients histologically diagnosed with cervical intraepithelial neoplasia (CIN) 1, CIN2/3, and invasive cervical cancer (ICC) between January 2014 and December 2017 were retrieved from the JKD database. Cytology and/or HR-HPV testing results within 3 months preceding the CIN1 diagnoses and 6 months preceding the CIN2/3 and ICC diagnoses were analyzed. Results: Prior screening data were available for 1829 CIN1 patients, 2309 CIN2/3 patients, and 680 ICC patients. Cytology alone and HR-HPV testing alone had similar rates of positive results for CIN2/3 (97.2% [854/879] vs. 95.4% [864/906], P = 0.105) and ICC detection (89.1% [205/230] vs. 92.7% [204/220], P = 0.185). Compared with either method alone, co-testing slightly increased the screening sensitivity for CIN2/3 (99.8% [523/524], all P < 0.001) and ICC (99.6% [229/230], all P < 0.001) detection. In the CIN1 group, cervical cytology alone (92.9% [520/560]) was more sensitive than HR-HPV testing alone (79.9% [570/713], P < 0.001), and co-testing (95.3% [530/556]) did not significantly improve the screening sensitivity (P = 0.105).

The Antibody Assay in Suspected Autoimmune Encephalitis From Positive Rate to Test Strategies

“…Patients who were diagnosed with suspected AE according to the published AE diagnostic criteria ( 1 , 13 ) in Guizhou Province between June 1, 2020, and June 30, 2021 and who had anti-neuronal antibodies detected by Guizhou KingMed Diagnostics Group Co., Ltd. were included in this study. KingMed is regarded as the pioneer and leader of the Independent Clinical Laboratories (ICL) industry and is the first ICL with both CAP and ISO15189 accreditation in China ( 14 ).…”

Reasons for truly negative cytology reports preceding the diagnoses of invasive cervical cancer—Results of a false‐negative cytology audit in Polish Cervical Cancer Screening Programme

“…21,22 This indicated that the quality of assessment screening cytology in Poland was suboptimal and needed improvement. The highest quality of cytology evaluation may be achieved by ongoing regular training and certification of staff involved in slides evaluation, as proposed by some studies 23 ; other researchers suggested that only the level of slides' difficulty influences the agreement rates rather than staff's academic or professional degrees. 24,25 The occurrence of 24.3% of truly normal slides sampled before CC diagnosis might have resulted from: (1) location of lesions deep in endocervical canal hampering appropriate sampling; (2) improper sampling and (3) true lack of lesions at the moment of sampling and their rapid development and progression.…”

“… 21 , 22 This indicated that the quality of assessment screening cytology in Poland was suboptimal and needed improvement. The highest quality of cytology evaluation may be achieved by ongoing regular training and certification of staff involved in slides evaluation, as proposed by some studies 23 ; other researchers suggested that only the level of slides' difficulty influences the agreement rates rather than staff's academic or professional degrees. 24 , 25 …”

Diagnostic value of dynamic enhanced multi-slice spiral CT in lymph node metastasis of cervical cancer and analysis of the causes of missed diagnosis

“…In addition, we also found that the negative expression of Ki-67 was closely related to the missed diagnosis by MSCT, as an independent risk factor. Probably, the patients with negative Ki-67 expression had lower cell proliferation [24], better prognosis and weaker lymph node metastasis [25]. Moreover, the model established based on the above independent influencing factors had high discrimination, accuracy, and predictive value.…”