绝经后妇女宫颈不典型鳞状细胞特点及转归

目的 探讨绝经后妇女的超薄液基细胞技术（TCT）结果中性质不明的不典型鳞状细胞（ASCUS）的特点及转归。方法 对198例绝经后妇女的TCT结果为ASCUS者进行分析总结，96例直接进行了阴道镜检查取活检病理诊断，102例先观察3月后复查TCT。阴道镜活检病理结果为宫颈上皮内瘤变（CIN）和复查TCT结果仍为ASCUS的行二代杂交捕获（HC2）实验，检测人乳头瘤病毒（HPV）-DNA。结果 ①96例阴道镜检查取活检病理诊断为CIN的19例（Ⅰ级12例，Ⅱ级7例），7例CINⅡ级行宫颈锥切后3月复查TCT为正常；②102例观察3月再复查TCT持续为ASCUS的18例，2例宫颈低度鳞状上皮内瘤变（LSIL），二者的异常率比较无统计学差异（P〉0．05）；③阴道镜检查活捡病理为CIN和TCT持续为ASCUS的共39例，进行HC2HPV—DNA检测结果均为阳性。结论 绝经后妇女的ASCUS特点是宫颈病变的比率低，表明其转归较好；有宫颈病变的老年患者均感染HPV，提示ASCUS中的绝经后妇女HPV的检测及治疗对于预防老年宫颈癌发生有重要意义。     

高危型人乳头状瘤病毒16、18型DNA检测联合液基薄层细胞学在宫颈癌筛查中的临床价值及随访

目的探讨高危型人乳头状瘤病毒(HPV)16、18型DNA检测联合液基薄层细胞学(TCT)对宫颈癌筛查的临床价值及随访情况。方法选择在该院进行宫颈癌筛查的480例患者,分别给予TCT检测、高危型HPV16、18检测及阴道镜下的宫颈活组织有关病理学检查。对比高危型HPV16、18及TCT联合检测与二者单独检测的诊断价值。随访1年后,对比3种检测方式对患者预后的诊断价值。结果 480例待筛查患者中,组织病理学结果显示,炎症病变246例,宫颈上皮内瘤变(CIN)Ⅰ141例,CINⅡ~Ⅲ82例,宫颈癌11例。高危型HPV16、18阳性对宫颈癌的检出率明显高于炎症病变、CINⅠ、CINⅡ~Ⅲ(均P<0.05)。TCT阳性结果对于宫颈癌的检出率明显高于炎症病变检出率(P<0.05),与CINⅠ、CINⅡ~Ⅲ的检出率比较无统计学差异(P>0.05)。高危型HPV16、18及TCT联合检测的特异度、阳性预测值均明显高于单独TCT检测及单独高危型HPV16、18检测(均P<0.05)。高危型HPV16、18及TCT联合检测对患者随访预后的诊断特异度及阳性预测值均高于单独TCT检测及单独高危型HPV16、18检测(均P<0.05)。结论应用高危型HPV16、18及TCT联合检测不仅能够更加有效地筛查宫颈癌等病变,而且对于患者的随访预后具有较好的预测诊断价值。     

薄层液基细胞学与人乳头瘤病毒联合检测在宫颈上皮病变筛查中的应用

目的 探讨薄层液基细胞学(TCT)与人乳头瘤病毒(HPV)联合检测在宫颈上皮病变筛查中的应用.方法 对在我院妇科门诊就诊和体检进行TCT联合HPV检测的妇女,选择单纯TCT阳性者121例为TCT组,单纯HPV阳性者169例为HPV组,两者均阳性者92例为TCT联合HPV组,三组均经阴道镜下取活检,以组织病理学为金标准,比较三组与组织病理学诊断的阳性预测值.分析TCT联合HPV检测双阳性与TCT和HPV单纯阳性在宫颈上皮病变筛查效果中有无差异.结果 TCT组、HPV组、TCT联合HPV组与组织病理学诊断的阳性预测值分7.02%、30.77%、75.00%.TCT联合HPV组与TCT组比较差异有统计学意义(χ2=7.40,P<0.05),TCT联合HPV组与HPV组比较差异有统计学意义(χ2=46.87,P<0.05).结论 TCT联合HPV检测筛查宫颈上皮病变明显优于TCT和HPV的单纯检测,是宫颈癌及癌前病变筛查较理想的方法.     

绝经后宫颈癌发病情况分析

目的了解绝经后宫颈癌的发病及临床病理特点,探讨绝经后宫颈癌早诊早治的手段及必要性。方法对23例宫颈癌患者临床资料进行回顾性分析,并以同期生育年龄宫颈癌28例作为对照。结果绝经组与育龄组比较,绝经组阴道接触性出血较育龄组发生率低（P〈0.01）,两组临床分期、淋巴结转移率、宫颈涂片细胞学检查阳性率、阴道镜检查及HPV检测阳性率无显著差异（P〈0.05）,绝经组宫颈腺癌发生率占3.8%,育龄组占17.85%（5/28）,两组中腺癌发生率差异显著（P〈0.01）。结论绝经后妇女宫颈癌发病期别通常较晚,绝经后宫颈病变筛查是必要的,定期妇科检查、宫颈涂片细胞学检查、阴道镜检查及高危型HPV检测可帮助绝经后妇女宫颈癌早诊早治。     

南宁市城市人群宫颈癌筛查方法的探讨

目的从经济学的角度探讨在南宁市进行人群宫颈癌筛查的最佳方法。方法选择2006～2009年以单位工会或社区统一组织的适龄妇女进行宫颈癌筛查的人群为对象,按自愿选择新柏氏薄层液基细胞学(TCT)+人乳头瘤病毒(HPV)、TCT、宫颈刮片+HPV、宫颈刮片、醋酸染色肉眼观察法(VIA)+碘染色肉眼观察法(VILI)五种宫颈癌筛查方法进行筛查,细胞学诊断≥ASCUS,VIA或VILI阳性的妇女进行阴道镜检查+活检。以病理诊断为金标准。对选择宫颈癌筛查五种方式的团体个数进行比较分析。结果 506个团体进行宫颈癌筛查的25～59岁妇女共12 507人,五种宫颈癌筛查方法的团体个数分别为43、59、60、182和162个,五种宫颈癌筛查方法的阳性率分别为10.32%、9.52%、5.48%、2.69%和4.48%。结论从经济学角度出发,VIA+VILI宫颈癌筛查方法是最适宜在南宁市开展人群宫颈癌筛查的方法。     

宫颈细胞 HPV E6／E7 mRNA 检测在宫颈病变诊断中的价值

目的：评价高危型人乳头状瘤病毒（ HPV） E6/E7 mRNA检测对宫颈病变的诊断价值。方法520例患者采用b-DNA技术检测HPV E6/E7 mRNA,并用宫颈液基细胞学（ TCT）行宫颈细胞学检查,对其中任何一项阳性者做阴道镜下宫颈活组织检查,以组织病理为金标准,计算HPV E6/E7 mRNA阳性对高级别宫颈上皮内瘤样病变（ CIN）、宫颈浸润癌诊断的灵敏度、特异度、阳性预测值、阴性预测值,并与TCT检查进行比较。结果520例患者中HPV E6/E7 mRNA阳性158例, TCT异常222例。 TCT 异常者中HPV E6/E7 mRNA阳性率较TCT 正常者中HPV E6/E7 mRNA阳性率高（P＜0．05）。146例慢性宫颈炎、CINⅠ级患者与124例高级别CIN、宫颈浸润癌患者中HPV E6/E7 mRNA阳性率比较,P＜0．05。 HPV E6/E7 mRNA阳性对高级别CIN及宫颈浸润癌诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为74．19％、83．33％、58．23％、71．43％,TCT 检查分别为81．53％、69．44％、81．45％、92．28％,两者特异度及阳性预测值比较, P均＜0．05。结论在宫颈癌筛查中检测高危型HPV E6/E7 mRNA对预测高级别CIN,尤其对评估癌症风险有重要的临床价值。     

TCT联合HC-Ⅱ筛查及药物干预宫颈病变的研究

目的探讨液基薄层细胞学检查（TCT）联合第二代基因杂交捕获法（HC-Ⅱ）检测高危型人乳头瘤病毒（HR-HPV）在宫颈病变筛查和治疗中的应用价值。方法宫颈病变筛查患者进行TCT、HC-Ⅱ高危型HPV检测及阴道镜下宫颈活检或宫颈管诊断性刮宫（ECC）检查。对宫颈上皮内瘤样病变（C IN）Ⅰ级HPV高危型感染患者应用干扰素α-2b凝胶（尤靖安）进行局部干预治疗,随访1 a。评估局部药物治疗对这部分患者的病毒检测量下降幅度、转阴率和病理逆转率的意义。结果 TCT和HC-Ⅱ检测HPV的灵敏度、特异度、一致率、阳性预测值、阴性预测值、约登指数分别为88.95%、35.05%、63.53%、60.55%、73.89%、0.24和81.40%、48.64%、65.95%、63.98%、70.00%、0.30。与HPV（-）＆TCT（-）组相比,HPV（＋）＆TCT（＋）组患者宫颈癌癌前病变的风险度明显增高（ORs=21.762）。采用干扰素α-2b凝胶治疗的C INⅠ级HPV高危型感染患者其病毒检测量下降幅度、转阴率和病理逆转率均明显高于对照组。结论 TCT联合HC-Ⅱ能够提高宫颈病变的特异性检出率,干扰素α-2b凝胶干预治疗可部分清除宫颈HPV高危型感染。     

HPV E6/E7 mRNA联合液基薄层细胞学检测在宫颈病变中的诊断价值

目的评价人乳头瘤病毒(HPV)E6/E7 mRNA检测联合液基薄层细胞学(TCT)方法在宫颈病变中的诊断价值。方法对750例高危型HPV DNA阳性患者分别进行TCT、HPVE6/E7 mRNA检测和阴道镜病理活检,比较HPV E6/E7 mRNA在各宫颈病变中阳性率的差异,以及比较单独检测和联合检测在宫颈病变中诊断价值的差异。结果 750例高危型HPV阳性患者进行阴道镜活检检出宫颈上皮内瘤变(CIN)和宫颈癌293例,E6/E7 mRNA阳性患者占286例,各种宫颈病变(意义不明不典型鳞状细胞、低度鳞状上皮内瘤变、高度鳞状上皮内瘤变、鳞状癌变)患者HPV E6/E7 mRNA阳性率差异有统计学意义(P<0.05)。单用TCT检出CIN阳性256例,单用E6/E7 mRNA检出CIN阳性247例,两者比较无统计学差异,单用TCT或E6/E7 mRNA检测出CIN阳性率均低于联合检测(P均<0.05)。结论 HPV E6/E7 mRNA检测联合TCT方法可降低宫颈病变的漏诊率,优于单独检测。     

集中与机会性筛查应用于绝经后宫颈病变患者的早期诊断

目的 探讨绝经后妇女宫颈病变的特点、筛查的必要性.方法 对313例妇女进行宫颈病变筛查,其中187例为社区宫颈癌普查者(对照组),126例为门诊妇科就诊已绝经患者(研究组).结果 研究组和对照组高危型人乳头瘤病毒(HPV)阳性率分别为43.85%、41.27%,二者无显著差异(P＞0.05);但两组HPV的阳性率均随宫颈病变程度的增加而增加(P＜0.05);研究组及对照组宫颈细胞异常的检出率分别为51.34%、49.21%,宫颈上皮内瘤变(CIN)分别为22.46%、19.05%,二者无显著差异(P＞0.05);研究组CINⅢ级发生率明显高于对照组(P＜0.05).结论 为早期发现宫颈病变,阻遏疾病进展为宫颈癌,在绝经后妇女进行宫颈细胞学筛查是必要的.     

HPV E6/E7 mRNA联合TCT在老年妇女宫颈疾病诊断中的临床应用价值

目的探讨人乳头瘤病毒(HPV) E6/E7 mRNA联合液基薄层细胞检测(TCT)在老年妇女宫颈疾病诊断中的临床应用价值。方法选取2015～2017年我院收治的疑似宫颈癌病人98例,分别采用HPV E6/E7mRNA以及TCT进行检测,分析其在宫颈疾病诊断中的临床应用价值。结果 HPV E6/E7 mRNA检查与病理检查结果差异无统计学意义(P0. 05),TCT检测结果与病理检查结果比较,差异均有统计学意义(P0. 05)。TCT联合HPV E6/E7 mRNA检测可以极大程度地提高检测的灵敏度(96. 2%)以及特异度(95. 0%)。结论在老年妇女宫颈疾病的诊断过程中,采用HPV E6/E7 mRNA联合TCT检查可以有效提高诊断准确率。     

High prevalence of human papillomavirus and cervical intraepithelial neoplasia in a young Australian STD population.

Two hundred and forty-five women consecutively attending a large city Sexually Transmitted Diseases (STD) Centre had routine cervical screening performed by both the Pap smear and, in addition, a Cervigram. The aim of this study was to determine the prevalence of HPV infection, CIN and cervical cancer in an STD population. The mean age of this group was 26 years with a range from 16 to 53 years. Colposcopy and biopsy revealed a prevalence for human papillomavirus (HPV) of 41%, and 20.4% for cervical intraepithelial neoplasia (CIN). No cases of cervical cancer were detected. The Pap smear detected HPV-associated change in 18% and CIN in 8.2%, therefore generally underestimating the true prevalence of HPV and CIN. Cervicography was positive in 44% of the total group, indicating either HPV-associated change or CIN. Current screening methods are therefore failing to detect significant amounts of HPV-associated change and CIN.     

Screening of cervical cancer by VIA among women in Rajshahi Medical College Hospital

ObjectiveTo find out different grades of cervical intraepithelial lesions of cervix with visual inspection of cervix with acetic acid (VIA).MethodsVIA was carried out in 540 eligible women attending Gynaecology Outpatient Department for gynecological problems. The women underwent a complete clinical evaluation. All screened women (540) were evaluated by colposcopy and biopsies which were taken from different quadrants of the cervix. The final diagnosis was based on histology, which allowed direct estimation of sensitivity, specificity, and predictive values of VIA and colposcopy. Those with abnormal lesions diagnosed by histology were considered as true positive.ResultsOut of 540 patients screened, 212 (39.27%) were VIA positive. More patients with cervical lesions were detected by VIA than colposcopy. There were 63 (11.67%) women with histologic cervical intraepithelial neoplasia (CIN I), which was found in 150 (27.78%) by VIA and 138 (25.56%) by colposcopy. VIA and colposcopy yielded high grade CIN II in the same number of patients. Biopsy proven cancer was found in 24 (4.45%) which was detected in 18 (3.33%) by VIA and colposcopy. Sensitivity and specificity of VIA were 68.50% and 70.45% respectively. Positive predictive value was 41.04% and negative predictive value was 90.85%.ConclusionsVIA can differentiate a normal cervix from a precancerous cervix with reasonable accuracy. The sensitivity and specificity of VIA are comparable to the other studies. So VIA may reduce the cervical intraepithelial lesions both in urban and rural areas.     

Detection of cervical intraepithelial neoplasia in developing countries

The reduction of cervical cancer mortality in developing countries is only one of many priorities competing for scarce funds. Incidence of cervical cancer may be up to six times higher in these countries than in developed countries due to lack of screening programs. The current WHO recommendation is to evaluate visual inspection as a way of identifying early curable cancer, as screening by cytology is too complex and expensive. Hence, an assessment of visual inspection aided by acetic acid (VIA) has been conducted in Zimbabwe. The study aimed to find out the true sensitivity, specificity, and positive predictive value (PPV) for high-grade CIN. The subject group was composed of 10,934 women screened by VIA and by exfoliative cervical cytology. The main findings of the study were that VIA was abnormal in about 20% of women; moreover, the test had a PPV of 25.9%, meaning that 3 out of 4 women would potentially be overtreated. VIA, however, represents a proven, simple means of identifying women in undeveloped health facilities, though level of training is probably critical to its success. Screening should go hand in hand with health education, which has proven valuable in reducing the rate of deaths from cervical cancer.     

Early detection of cervical cancer with visual inspection methods: a summary of completed and on-going studies in India

India is a high-risk country for cervical cancer which accounts a quarter (126,000 new cases, 71,000 deaths around 2,000) of the world burden. The age-standardized incidence rates range from 16-55 per 100,000 women in different regions with particularly high rates in rural areas. Control of cervical cancer by early detection and treatment is a priority of the National Cancer Control Programme of India. There are no organized cytology screening programmes in the country. The technical and financial constraints to organize cytology screening have encouraged the evaluation of visual inspection approaches as potential alternatives to cervical cytology in India. Four types of visual detection approaches for cervical neoplasia are investigated in India: a) naked eye inspection without acetic acid application, widely known as 'downstaging'; b) naked eye inspection after application of 3-5% acetic acid (VIA); c) VIA using magnification devices (VIAM); d) visual inspection after the application of Lugol's iodine (VILI). Downstaging has been shown to be poorly sensitive and specific to detect cervical neoplasia and is no longer considered as a suitable screening test for cervical cancer. VIA, VIAM and VILI are currently being investigated in multicentre cross-sectional studies (without verification bias), in which cytology and HPV testing are also simultaneously evaluated, and the results of these investigations will be available in 2003. These studies will provide valuable information on the average, comparative test performances in detecting high-grade cervical cancer precursors and cancer. Results from pooled analysis of data from two completed studies indicated an approximate sensitivity of 93.4% and specificity of 85.1% for VIA to detect CIN 2 or worse lesions; the corresponding figures for cytology were 72.1% and 91.6%. The efficacy of VIA in reducing incidence of an mortality from cervical cancer and its cost-effectiveness is currently being investigated in two cluster randomized controlled intervention trials in India. One of these studies is a 4-arm trial addressing the comparative efficacy of VIA, cytology and primary screening with HPV DNA testing. This trial will provide valuable information on comparative detection rates of CIN 2-3 lesions by the middle of 2003. The expected outcomes from the Indian studies will contribute valuable information for guiding the development of public health policies on cervical cancer prevention in countries with different levels of socio-economic and health services development and open up new avenues of research. This paper is available too at: http//www.insp.mx/salud/index.html.     

Screening for cervical cancer: new alternatives and research

Evidence for the clinical utility of human papillomavirus (HPV) DNA testing has increased over the years and has now become very convincing. Some specific uses of HPV detection are a) triage of women with cytological determinations of atypical squamous cells of undetermined significance (ASC-US) and related management strategies, b) as a marker for test of cure post-treatment, and c) most importantly, as an adjunct to cytology in routine cervical disease screening programs. There are many studies that support each of these applications and include 8 studies on ASC-US triage, 10 on test of cure and 13 on adjunctive or stand-alone HPV screening. The most notable investigation of ASC-US triage was ALTS, a randomized controlled trial of 3,488 women. With respect to routine HPV screening the combined studies included 77,000 women, providing as a histological endpoint more than 1,000 cases of high-grade cervical intraepithelial neoplasia (CIN) or cancer. Testing methods were either the Hybrid Capture 2 (HC2) test or the polymerase chain reaction (PCR) test. HPV testing of women with ASC-US cytology had on average a higher sensitivity (90%) and specificity (70%) than repeating the cytological test (sensitivity 75%, specificity 60%) and was also more sensitive than colposcopy for follow-up. As an adjunct to the Papanicolaou (Pap) cytology test in routine screening, HPV DNA testing was a more sensitive indicator for prevalent high-grade CIN than either conventional or liquid cytology. A combination of HPV DNA and Papanicolaou testing had almost 100% sensitivity and negative predictive value. The specificity of the combined tests was slightly lower than the specificity of the Papanicolaou test. One "double-negative" HPV DNA and Papanicolaou test indicated a higher prognostic assurance against risk of future CIN 3 than three subsequent negative conventional Papanicolaou tests and may safely allow three-year or longer screening intervals for such low-risk women. It appears that HPV DNA testing is on the way to becoming a common testing strategy in cervical cancer prevention programs. Research continues into approaches for improving the performance and cost-effectiveness of HPV detection methods. Hybrid Capture 3 will offer improved HPV typing capabilities and the Rapid Capture machine allows for robot-assisted HPV DNA testing, permitting greater test throughput. PCR test improvements are expected to contribute to the growth of flexible accurate and cost-effective HPV DNA tests. It is likely that improved diagnostic technology along with HPV genotyping and quantitation may provide more value in future. A particularly promising approach is to combine HPV DNA testing with expression levels of other markers such as proliferative or cell cycle regulatory proteins to subdivide HPV-positive women into those who are at greater risk of cancer and those who can be safely followed by screening at longer intervals. This paper is available too at: http://www.insp.mx/salud/index.html.     

Comparison of visual inspection and Papanicolau (PAP) smears for cervical cancer screening in Honduras: should PAP smears be abandoned?

OBJECTIVE: To compare visual inspection with acetic acid (VIA) to Papanicolau (PAP) smears in a community setting in a developing nation. METHODS: Women undergoing cervical cancer screening in Honduras received either VIA and PAP smears (VIA/PAP group) or PAP smears alone (PAP-only group). Local healthcare providers performed PAP screening. A VIA-trained nurse performed VIA exams. All PAP smears were processed in Honduras. PAP smears from the VIA/PAP group were reviewed in the United States. Women with positive VIA or PAP tests were offered colposcopy. We compared the relative accuracy of PAP smears and VIA and the proportions of women completing follow-up colposcopy after positive screening tests. RESULTS: In total, 1709 PAP smears were performed including women from both the VIA/PAP and PAP-only groups. Nine PAP smears were positive (0.5%). Three women completed colposcopy (33%). All three had biopsy-confirmed dysplasia. In the VIA/PAP group (n = 339), 49 VIA exams were abnormal (14%) and two PAP smears were abnormal when read in Honduras (0.6%). When reviewed in the United States, 14 of the 339 PAP smears were abnormal (4%). Forty women (83%) completed follow-up colposcopy after a positive VIA exam. Twenty-three had biopsy-proven dysplasia. All 23 dysplasia cases had negative PAP smear readings in Honduras; four PAP smears were reclassified as positive in the United States. CONCLUSIONS: Although few developing countries can maintain high-quality PAP smear programmes, many governments and charitable organizations support cervical cancer screening programmes that rely on PAP smears. This study underscores the need to promote alternative technologies for cervical cancer screening in low-resource settings.     

贵州地区宫颈上皮内瘤变和宫颈浸润癌患者HPV感染状态及其亚型分布

目的观察贵州地区宫颈上皮内瘤变（CIN）和宫颈浸润癌患者人乳头状瘤病毒（HPV）的感染状态及其亚型分布。方法采用导流杂交技术对30例CIN（CIN组）、33例宫颈浸润癌患者（宫颈癌组）、60例自愿接受宫颈HPV感染筛查的妇女（对照组）进行HPV分型检测,所有受检者均来自贵州地区。结果 CIN组HPV阳性13例（43.33%）,宫颈癌组19例（57.58%）,对照组5例（8.33%）。CIN组、宫颈癌组与对照组比较,P均〈0.01。CIN组共检出7种亚型HPV,均为高危型（HR-HPV）,无多型HPV感染（M-HPV）。其中HPV16 7例,HPV31、52各2例,HPV18、33、53、58各1例。宫颈癌组检出5种亚型,亦均为HR-HPV,M-HPV3例。其中HPV16 11例,HPV534例,HPV58 3例,HPV18、59各1例。对照组检出7种亚型,HR-HPV中的HPV16、18、31、39、53、58和低危型HPV的HPV6各1例;M-HPV 1例。CIN组、宫颈癌组HPV16感染率明显高于对照组,P均〈0.05。HR-HPV感染与CIN（OR=8.412,95%CI为2.62~26.99）和宫颈浸润癌（OR=14.929,95%CI为4.74~46.98）紧密相关,且主要与HPV16感染有关（CIN：OR=17.957,95%CI为2.09~154.15;宫颈浸润癌：OR=29.500,95%CI为3.60~242.07）,P均〈0.05。结论贵州地区CIN和宫颈浸润癌与HR-HPV感染密切相关,HPV16为主要感染亚型。     

Diagnostic accuracy of novel folate receptor-mediated staining solution detection (FRD) for CIN2+: A systematic review and meta analysis

Background:Early detection and diagnosis of high-grade cervical intraepithelial neoplasia grade 2 or higher (CIN2+) is critical for a good prognosis and appropriate treatment. The chief aim of our study was to evaluate the diagnostic performance of folate receptor-mediated staining solution detection (FRD) for CIN2+.Methods:We conducted a systematic review and meta-analysis by searching the PubMed and EMBASE databases for studies published until May 2020, which assessed the diagnostic accuracy of FRD, human papilloma virus (HPV) testing, and ThinPrep cytology test (TCT) for the detection of CIN2+. Bivariate models were used to compare the diagnostic performance of FRD, HPV, and TCT.Results:Six studies involving 2817 patients were included in this meta-analysis. The pooled specificity of FRD was higher than that of HPV and TCT for detecting CIN2+ (0.65, 0.12, and 0.39, respectively). The summary area under the receiver operating characteristic curve values using FRD, HPV, and TCT for detecting CIN2+ were 0.79, 0.95, and 0.77, respectively, indicating that FRD was superior to TCT. The diagnostic odds ratios of FRD, HPV, and TCT were 6 (95% CI: 5–7), 3 (95% CI: 2–5), and 3 (95% CI: 2–4), respectively, demonstrating that FRD had good diagnostic accuracy.Conclusion:FRD showed good diagnostic accuracy and higher specificity than HPV and TCT for detecting CIN2+. Based on our results, we propose that FRD could be a candidate for cervical screening, especially in underdeveloped countries.