Evaluation of folate receptor mediated methylene blue dye as cervical cancer screening algorithms
ZHU Yanling1，ZHANG Jie1，LIU Beibei1，ZHANG Xueling2，ZHANG Hong1，ZHANG Ping1，WANG Xinxia1，YU Xiaojuan1，WANG Lan1
（1.Xuzhou Cancer Hospital，Xuzhou 221005，Jiangsu，China；2.The People s Hospital of Dawu Town，Xuzhou 221132，Jiangsu，China)
Abstract: Objective It is to find out cervical cancer screening algorithms suitable for economically underdeveloped areas or grassroots health institutions, in order to expand the coverage of cervical cancer screening and promote the prevention and control of cervical cancer in China. Methods 1671 women were voluntary to undergo the cervical cancer screening included Folate receptor mediated methylene blue dye staining（FRD）and Thin-Cytologic Test (TCT). Each woman underwent colposcopy and biopsy or endocervical curettage. Screening results were evaluated by the gold standard based on histopathological diagnosis. The performance indexes of the algorithms such as sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic (ROC) curve for detecting the high grade lesions (CIN2) were compared. Results For the FRD as the screening test, its sensitivity was 91.0%, specificity was 75.7%, positive predictive value was 21.4%, and negative predictive value was 99.2%, For the TCT as the screening test, its sensitivity was 79.3%, specificity was 90.4%, the positive predictive value was 37.1%, and the negative predictive value was 98.4%. There was no statistically significant differences in ROC area under the curve between the two methods (Z= 0 559, P＞ 0.05).For the combination test of FRD and TCT as the screening test, the sensitivity, specificity, positive predictive value and negative predictive value were 100.0%, 73.8%, 21.3% and 100.0% respectively. Combination test of FRD and TCT was obviously superior to the screening test of FRD alone, and the difference was statistically significant(Z= 1825,P＜ 0.05); There was no statistically significant differences between the combination test and TCT alone (Z= 0 797, P＞ 0.05). Conclusion Screening test of FRD is suitable for underdeveloped regions with large population and grassroots health institutions with insufficient medical technology. Considering the health-resource and women’s preference, combination test of FRD and TCT may be chosen as the screening approach in developed regions.
Key words: cervical neoplasm; screening tests; Folate receptor mediated methylene blue dye staining
Published in Modern Journal of Integrated Traditional Chinese and Western Medicine, 2015, 24(14)