Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introdu...Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.展开更多
基于数控系统绕刀具中心旋转(Rotation tool center point,RTCP)功能,R-test装置被用于多轴联动数控机床的联动精度检测与标定。该仪器通过三个直线位移传感器测量安装于主轴的球头球心空间位置,从而可测量机床多轴联动时的刀具中心点...基于数控系统绕刀具中心旋转(Rotation tool center point,RTCP)功能,R-test装置被用于多轴联动数控机床的联动精度检测与标定。该仪器通过三个直线位移传感器测量安装于主轴的球头球心空间位置,从而可测量机床多轴联动时的刀具中心点位置误差。在分析测量原理的基础上,提出最大测量空间和测量敏感度的两个用于评价测量性能的指标及相应的数值算法,得到一种R-test装置结构优化设计方法。在选择通用球头芯棒与长度计的情况下,通过约束分析得到测量杆安装圆直径、测量杆与基准面夹角两个关键尺寸的设计区间,利用蒙特卡罗法搜索得到这两个关键尺寸的最优解,完成结构优化设计。仿真表明,优化设计得到的R-test测量装置具有最佳的测量敏感度,可测区域大于半径为4 mm的球体,能满足实际测量精度和测量空间需要。展开更多
Meta-Test是一款专门用于诊断准确性试验(diagnostic test accuracy,DTA)Meta分析的常用软件。Meta-Test软件运行基于DOS系统,能以一种简单而直接地方式进行准确的数据处理和绘制精美而信息丰富的图形,并能进行亚组分析。其方便且有提...Meta-Test是一款专门用于诊断准确性试验(diagnostic test accuracy,DTA)Meta分析的常用软件。Meta-Test软件运行基于DOS系统,能以一种简单而直接地方式进行准确的数据处理和绘制精美而信息丰富的图形,并能进行亚组分析。其方便且有提示的操作、准确可靠数据处理及强大可用的绘图功能,使得其目前在DTA Meta分析中仍使用较为频繁,但其缺陷在于无法实现十字交叉图、散点图与边缘密度图的绘制。本文以一组DTA Meta分析的数据为例,系统展示本软件对数据的准备与分析、结果汇总及图形绘制等功能的相关操作过程。展开更多
文摘Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.
文摘基于数控系统绕刀具中心旋转(Rotation tool center point,RTCP)功能,R-test装置被用于多轴联动数控机床的联动精度检测与标定。该仪器通过三个直线位移传感器测量安装于主轴的球头球心空间位置,从而可测量机床多轴联动时的刀具中心点位置误差。在分析测量原理的基础上,提出最大测量空间和测量敏感度的两个用于评价测量性能的指标及相应的数值算法,得到一种R-test装置结构优化设计方法。在选择通用球头芯棒与长度计的情况下,通过约束分析得到测量杆安装圆直径、测量杆与基准面夹角两个关键尺寸的设计区间,利用蒙特卡罗法搜索得到这两个关键尺寸的最优解,完成结构优化设计。仿真表明,优化设计得到的R-test测量装置具有最佳的测量敏感度,可测区域大于半径为4 mm的球体,能满足实际测量精度和测量空间需要。
文摘Meta-Test是一款专门用于诊断准确性试验(diagnostic test accuracy,DTA)Meta分析的常用软件。Meta-Test软件运行基于DOS系统,能以一种简单而直接地方式进行准确的数据处理和绘制精美而信息丰富的图形,并能进行亚组分析。其方便且有提示的操作、准确可靠数据处理及强大可用的绘图功能,使得其目前在DTA Meta分析中仍使用较为频繁,但其缺陷在于无法实现十字交叉图、散点图与边缘密度图的绘制。本文以一组DTA Meta分析的数据为例,系统展示本软件对数据的准备与分析、结果汇总及图形绘制等功能的相关操作过程。
