{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:00:40Z","timestamp":1785463240568,"version":"3.56.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100010804","name":"Faculty of Medicine, Prince of Songkla University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Cervical cancer remains a major public health burden in low\u2010 and middle\u2010income countries, primarily caused by high\u2010risk human papillomavirus (hrHPV) infection. Although HPV DNA testing is highly sensitive, its low specificity necessitates effective triage strategies. Cycle threshold (CT) values from real\u2010time polymerase chain reaction assays reflect viral load and might serve as potential biomarkers for triage; however, their clinical significance remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included women aged 25\u201365\u2009years who tested positive for hrHPV between September 2023 and April 2025 at three Southern Thailand hospitals. All participants had CT values and underwent colposcopy with biopsy. HPV testing was performed using the Allplex HPV HR Detection assay, and diagnostic performance was evaluated using receiver operating characteristic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 677 hrHPV\u2010positive women, 286 met the eligibility criteria, with cervical intraepithelial neoplasia 2 or higher (CIN2+) detected in 56 (19.6%). HPV16, HPV52, and HPV58 were the most common genotypes in CIN2+ cases. CT values were significantly inversely correlated with lesion severity (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.13,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.025). For non\u201016\/18 hrHPV infections, a CT cutoff value of &lt;32.94 improved the area under the curve from 0.54 to 0.65, yielding a sensitivity and specificity of 89% and 41%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cycle threshold values demonstrated modest discriminatory performance. Therefore, they should not be used as the sole biomarkers for triage; rather, they should be used as a supplementary tool to aid in clinical decision\u2010making. Further validation in larger prospective studies is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70785","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T09:02:48Z","timestamp":1767690168000},"page":"1617-1627","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic performance of human papillomavirus\n                    <scp>DNA<\/scp>\n                    cycle threshold values in the detection of high\u2010grade cervical intraepithelial neoplasia"],"prefix":"10.1002","volume":"173","author":[{"given":"Pattharapa","family":"Watcharasin","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Prince of Songkla University  Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathapol","family":"Sirimusika","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hatyai Hospital  Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3460-8236","authenticated-orcid":false,"given":"Thiti","family":"Atjimakul","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Prince of Songkla University  Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-5569","authenticated-orcid":false,"given":"Athithan","family":"Rattanaburi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Faculty of Medicine, Prince of Songkla University  Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834.s"},{"key":"e_1_2_14_3_1","volume-title":"Global Cancer Observatory: Cancer Today","author":"Ferlay J","year":"2024"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61416-0"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9896(199909)189:1<>3.0.CO;2-F"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju153"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2014.12.022"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31261"},{"key":"e_1_2_14_10_1","volume-title":"WHO guideline for screening and treatment of cervical pre\u2010cancer lesions for cervical cancer prevention","author":"World Health Organization","year":"2021"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.13174"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000525"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000802"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.21473"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/gocm-2024-000032"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232107"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1010066"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220200"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232117"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13027-022-00440-4"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0107573"},{"key":"e_1_2_14_22_1","first-page":"3147","article-title":"Prevalence and associated factors of abnormal cervical cytology and HighRisk HPV DNA among Bangkok metropolitan women","volume":"17","author":"Tangjitgamol S","year":"2016","journal-title":"Asian Pac J Cancer Prev"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2017.06.003"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13027-015-0001-5"},{"key":"e_1_2_14_25_1","article-title":"Genotyping for human papil\u2010lomavirus (HPV) 52 and 58 identifies women with high\u2010grade cervical neoplasia among HPV16\/18\u2010negative women with low\u2010grade abnormal cytology","volume":"11","author":"Khunamornpong S","year":"2016","journal-title":"PLoS One"},{"key":"e_1_2_14_26_1","volume-title":"Allplex\u2122 HPV HR Detection","author":"Seegene Inc","year":"2019"},{"key":"e_1_2_14_27_1","volume-title":"Human Papillomavirus and Related Diseases in the World","author":"Bruni L","year":"2023"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/2045-3701-2-17"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01097-3"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.31557\/APJCP.2025.26.9.3353"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.70561"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-2023-004424"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-09126-3"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.7464"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.7316"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-0239"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24021320"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2017.11.016"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-054290"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70785","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70785","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70785","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:43:00Z","timestamp":1785462180000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70785"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/ijgo.70785"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70785","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]},"assertion":[{"value":"2025-10-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}