ความสัมพันธ์ระหว่างค่ารอบเกณฑ์จากการตรวจหาเชื้อเอชพีวีชนิดเสี่ยงสูงในตัวอย่างที่เก็บด้วยตนเอง      กับการเกิดรอยโรคที่ปากมดลูกระดับสูง จากผลตรวจทางพยาธิวิทยา ในโรงพยาบาลตรัง

Siboonluk  Lukkhan

Authors

Siboonluk Lukkhan Department of Obstetrics and Gynecology, Trang Hospital

Keywords:

Cervical cancer screening, Human papillomavirus infection, High-risk HPV testing in self-collected samples, Cycle threshold, Cervical cancer

Abstract

Background: Cervical cancer is strongly associated with high-risk human papillomavirus (HPV) infection. Cycle threshold (Ct) values obtained from HPV testing may reflect viral load and correlate with the risk of high-grade cervical lesions. This study aimed to evaluate the association between Ct values from self-collected HPV samples and high-grade cervical lesions at Trang Hospital.

Methods: A retrospective cohort study was conducted among Thai women aged 30–60 years who underwent high-risk HPV testing using self-collected samples and subsequent colposcopy between January 1 and December 31, 2025. Logistic regression analysis was used to assess the association between Ct values and histopathologic outcomes. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal Ct cut-off value.

Results: A total of 178 patients were included. Lower Ct values were significantly associated with high-grade cervical lesions (OR 0.925, 95% CI 0.877–0.976, p=0.005). Longer waiting time before colposcopy was also associated with increased risk of high-grade lesions (OR 1.006, 95% CI 1.000–1.012, p=0.034). The Ct value demonstrated limited discriminatory ability with an area under the ROC curve of 0.658. The optimal cut-off value was ≤30.21, yielding a sensitivity of 68% and specificity of 62%.

Conclusion: Ct values from self-collected HPV testing were associated with high-grade cervical lesions; however, their discriminatory performance was limited. Ct values should therefore be used in combination with other clinical factors for risk stratification.

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