Cervical cancer remains a concern worldwide, and cervical cancer screening plays an important role in reducing the burden of this disease. Although cytology is still the main strategy for cervical cancer screening, it has gradually changed to human papillomavirus testing. The specificity of human papillomavirus testing is lower than that of cytology, which leads to an increased rate of colposcopy after positive results. To decrease colposcopic examinations, an efficient triage method is needed for human papillomavirus screening. New biomarkers have been developed and evaluated for primary screening and triage of abnormal cytology or human papillomavirus-positive results. Their sensitivity and specificity were estimated and compared with those of cytology. In the present study, the following new techniques were examined: p16/Ki67 dual staining, DNA methylation, micro-ribonucleic acid, chromosomal abnormalities, Claudins and DNA ploidy. Evaluation studies of p16/Ki67 dual staining and DNA methylation were more advanced than those of other options. When p16/Ki67 dual staining was used for triage for human papillomavirus testing, the sensitivity of 2 or greater cervical intraepithelial neoplasia (CIN2+) detection was higher than that of cytology without decreased specificity. Although there are several types of DNA methylation, sensitivity and specificity were moderate for detecting CIN2+. S5 classifier is a commercialized product that consists of viral methylation, and high sensitivity with decreased specificity has been reported. Considering its combination with self-sampling, DNA methylation is a highly anticipated technique along with human papillomavirus testing for the next generation of cervical cancer screening. However, the backgrounds for cervical cancer screening differ among countries and further study is needed to identify the best available method.

中文翻译：

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宫颈癌筛查的新兴技术

宫颈癌仍然是全世界关注的问题，宫颈癌筛查在减轻这种疾病的负担方面发挥着重要作用。虽然细胞学仍是宫颈癌筛查的主要策略，但已逐渐转变为人乳头瘤病毒检测。人乳头瘤病毒检测的特异性低于细胞学，导致阴道镜检查阳性率增加。为了减少阴道镜检查，需要一种有效的分流方法来筛查人乳头瘤病毒。已经开发和评估了新的生物标志物，用于对异常细胞学或人乳头瘤病毒阳性结果的初步筛查和分类。评估了它们的敏感性和特异性，并与细胞学的敏感性和特异性进行了比较。在本研究中，检查了以下新技术：p16/Ki67 双染色，DNA 甲基化、微核糖核酸、染色体异常、密蛋白和 DNA 倍性。p16/Ki67 双染色和 DNA 甲基化的评估研究比其他选项更先进。当 p16/Ki67 双染色用于人乳头瘤病毒检测的分类时，2 或更大的宫颈上皮内瘤变 (CIN2+) 检测的敏感性高于细胞学的敏感性，但特异性没有降低。尽管存在多种类型的 DNA 甲基化，但检测 CIN2+ 的敏感性和特异性适中。S5 分类器是一种商业化产品，由病毒甲基化组成，据报道具有高灵敏度和降低的特异性。考虑到它与自采样的结合，DNA 甲基化与人类乳头瘤病毒检测一起是一种备受期待的技术，用于下一代宫颈癌筛查。然而，宫颈癌筛查的背景因国家而异，需要进一步研究以确定最佳可用方法。