{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:01:38Z","timestamp":1787169698906,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T00:00:00Z","timestamp":1655856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007403","name":"Dagmar Marshalls Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007403","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016545","name":"Roche Diagnostics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the clinical utility of p16\/Ki67 dual\u2010stain (DS) compared with cytology for detecting cervical intraepithelial lesion grade two or worse (CIN2+) in women with a transformation zone type 3 (TZ3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Colposcopy clinics in Central Denmark Region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Women aged 45\u2009years or older referred for colposcopy because of an abnormal screening test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All women had a cervical sample collected for cytology and DS testing and underwent large\u2010loop excision of the transformation zone (LLETZ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measure<\/jats:title>\n                    <jats:p>Sensitivity, specificity and negative (NPV) and positive (PPV) predictive values of DS for CIN2+ detection were compared to those of cytology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 166 women eligible, 93 (56.0%) were included in the final analysis. Median age was 68\u2009years (interquartile range [IQR] 63.4\u201370.5\u2009years). Most women were postmenopausal (95.7%) and referred based on a positive human papillomavirus screening test (86.0%). Fifty\u2010two women (55.9%) were DS\u2010positive, 29 (55.8%) of whom had CIN2+ detected. Twenty\u2010seven (29.0%) women had atypical squamous cells of undetermined significance or worse (ASC\u2010US+), and CIN2+ was detected in 21 women (77.8%). DS had a higher sensitivity (96.7% versus 70.0%\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.021) and NPV (97.6% versus 86.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.018) compared with cytology for CIN2+ detection. In contrast, the specificity (63.5% versus 90.5%\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and PPV (55.8% versus 77.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001) were lower for DS compared with cytology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dual stain may be a valuable risk marker to guide clinical management of women with a TZ3. The superior NPV of DS suggests that a diagnostic excision may safely be avoided in DS\u2010negative women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17248","type":"journal-article","created":{"date-parts":[[2022,6,10]],"date-time":"2022-06-10T05:10:11Z","timestamp":1654837811000},"page":"202-209","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Clinical utility of p16\/Ki67 dual\u2010stain cytology for detection of cervical intraepithelial neoplasia grade two or worse in women with a transformation zone type 3: A cross\u2010sectional study"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-4708","authenticated-orcid":false,"given":"Line Winther","family":"Gustafson","sequence":"first","affiliation":[{"name":"University Research Clinic for Cancer Screening, Department of Public Health Programmes Randers Regional Hospital  Randers Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynaecology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Tranberg","sequence":"additional","affiliation":[{"name":"University Research Clinic for Cancer Screening, Department of Public Health Programmes Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia N\u00f8rgaard","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Pathology Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rikke","family":"Br\u00f8ndum","sequence":"additional","affiliation":[{"name":"Department of Pathology Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Wentzensen","sequence":"additional","affiliation":[{"name":"Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan A.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics National Cancer Institute  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berit","family":"Andersen","sequence":"additional","affiliation":[{"name":"University Research Clinic for Cancer Screening, Department of Public Health Programmes Randers Regional Hospital  Randers Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lone Kjeld","family":"Petersen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Odense University Hospital and Open Patient Data Explorative Network  Odense Denmark"},{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinar","family":"Bor","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynaecology Randers Regional Hospital  Randers Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4616-9827","authenticated-orcid":false,"given":"Anne","family":"Hammer","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"},{"name":"Department of Obstetrics and Gynaecology NIDO Denmark, G\u00f8dstrup Hospital  Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2016.290"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.55.9948"},{"key":"e_1_2_11_4_1","volume-title":"Colposcopy and treatment of cervical precancer","author":"Prendiville W","year":"2017"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.17200"},{"key":"e_1_2_11_6_1","unstructured":"Gynecology SSoOa.SFOG\u2010riktlinje av NVP f\u00f6r cervixcancerprevention. 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