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Garrido F, Wild CM, Jeschke U, Dannecker C, Mayr D, Cavailles V, Mahner S, Kost B, Heidegger HH, Vattai A. Expression of Progesterone Receptor A as an Independent Negative Prognosticator for Cervical Cancer. Int J Mol Sci 2023; 24:ijms24032815. [PMID: 36769131 PMCID: PMC9917985 DOI: 10.3390/ijms24032815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
The role of progesterone receptor A (PRA) for the survival outcome of cervical cancer patients is ambiguous. In mouse models, it has been shown that PRA plays a rather protective role in cancer development. The aim of this study was to assess its expression by immunohistochemistry in 250 cervical cancer tissue samples and to correlate the results with clinicopathological parameters including patient survival. PRA expression was positively correlated with the International Federation of Gynecology and Obstetrics (FIGO) classification scores. PRA was significantly overexpressed in adenocarcinomas compared to squamous epithelial carcinoma subtypes. Correlation analyses revealed a trend association with the HPV virus protein E6, a negative correlation with p16 and a positive correlation with EP3. PRA expression was also associated with the expression of RIP140, a transcriptional coregulator that we previously identified as a negative prognostic factor for survival in cervical cancer patients. Univariate survival analyses revealed PRA as a negative prognosticator for survival in patients with cervical adenocarcinoma. Multivariate analyses showed that simultaneous expression of RIP140 and PRA was associated with the worst survival, whereas with negative RIP140, PRA expression alone was associated with the best survival. We can therefore assume that the effect of nuclear PRA on overall survival is dependent upon nuclear RIP140 expression.
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Affiliation(s)
- Fabian Garrido
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Carl Mathis Wild
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
- Department of Data Management and Clinical Decision Support, Faculty of Medicine, University of Augsburg, 86159 Augsburg, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
- Correspondence: ; Tel.: +49-89-4400-54240
| | - Christian Dannecker
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Doris Mayr
- Department of Pathology, LMU Munich, 80337 Munich, Germany
| | - Vincent Cavailles
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, Université Montpellier, F-34298 Montpellier, France
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Bernd Kost
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Helene H. Heidegger
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany
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Smith CA, Chang MM, Kundrod KA, Novak EN, Parra SG, López L, Mavume C, Lorenzoni C, Maza M, Salcedo MP, Carns JL, Baker E, Montealegre J, Scheurer M, Castle PE, Schmeler KM, Richards-Kortum RR. A low-cost, paper-based hybrid capture assay to detect high-risk HPV DNA for cervical cancer screening in low-resource settings. LAB ON A CHIP 2023; 23:451-465. [PMID: 36562325 PMCID: PMC9890501 DOI: 10.1039/d2lc00885h] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
Cervical cancer is a leading cause of cancer death for women in low-resource settings. The World Health Organization recommends that cervical cancer screening programs incorporate HPV DNA testing, but available tests are expensive, require laboratory infrastructure, and cannot be performed at the point-of-care. We developed a two-dimensional paper network (2DPN), hybrid-capture, signal amplification assay and a point-of-care sample preparation protocol to detect high-risk HPV DNA from exfoliated cervical cells within an hour. The test does not require expensive equipment and has an estimated cost of <$3 per test without the need for batching. We evaluated performance of the paper HPV DNA assay with short synthetic and genomic HPV DNA targets, HPV positive and negative cellular samples, and two sets of clinical samples. The first set of clinical samples consisted of 16 biobanked, provider-collected cervical samples from a study in El Salvador previously tested with careHPV and subsequently tested in a controlled laboratory environment. The paper HPV DNA test correctly identified eight of eight HPV-negative clinical samples and seven of eight HPV-positive clinical samples. We then performed a field evaluation of the paper HPV DNA test in a hospital laboratory in Mozambique. Cellular controls generated expected results throughout field testing with fully lyophilized sample preparation and 2DPN reagents. When evaluated with 16 residual self-collected cervicovaginal samples previously tested by the GeneXpert HPV assay ("Xpert"), the accuracy of the HPV DNA paper test in the field was reduced compared to testing in the controlled laboratory environment, with positive results obtained for all eight HPV-positive samples as well as seven of eight HPV-negative samples. Further evaluation showed reduction in performance was likely due in part to increased concentration of exfoliated cells in the self-collected clinical samples from Mozambique compared with provider-collected samples from El Salvador. Finally, a formal usability assessment was conducted with users in El Salvador and Mozambique; the assay was rated as acceptable to perform after minimal training. With additional optimization for higher cell concentrations and inclusion of an internal cellular control, the paper HPV DNA assay offers promise as a low-cost, point-of-care cervical cancer screening test in low-resource settings.
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Affiliation(s)
- Chelsey A Smith
- Department of Bioengineering, Rice University, Houston, TX, USA.
| | - Megan M Chang
- Department of Bioengineering, Rice University, Houston, TX, USA.
| | | | - Emilie N Novak
- Department of Bioengineering, Rice University, Houston, TX, USA.
| | - Sonia G Parra
- Department of Bioengineering, Rice University, Houston, TX, USA.
| | - Leticia López
- Basic Health International, San Salvador, El Salvador
| | | | - Cesaltina Lorenzoni
- Hospital Central de Maputo, Maputo, Mozambique
- Ministerio da Saude de Moçambique (MISAU), Maputo, Mozambique
| | - Mauricio Maza
- Basic Health International, San Salvador, El Salvador
| | - Mila P Salcedo
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer L Carns
- Department of Bioengineering, Rice University, Houston, TX, USA.
| | - Ellen Baker
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jane Montealegre
- Department of Pediatrics-Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Michael Scheurer
- Department of Pediatrics-Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Philip E Castle
- Divisions of Cancer Prevention and Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Kathleen M Schmeler
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Luo H, Zhu Y, Wang J, Wang Y, Wei L. Comprehensive profile and contrastive analysis of circular RNA expression in cervical squamous carcinoma and adenocarcinoma. PeerJ 2023; 11:e14759. [PMID: 36721776 PMCID: PMC9884480 DOI: 10.7717/peerj.14759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background Numerous studies have shown circular RNA (circRNA) dysregulation is associated with the pathogenesis of cervical cancer,particularly in individual carcinoma variants. The aim of this study is to investigate and contrastively analyze the expression pattern of circRNAs in cervical squamous carcinoma and adenocarcinoma mediated by human papillomavirus type 16 (HPV-16). Methods The expression of circRNAs in cervical squamous carcinoma (SCC), adenocarcinoma (ADC) and adenosquamous carcinoma (ASC) tissues, together with the adjacent normal tissues (ANT), was profiled by high-throughput RNA sequencing (RNA-seq). Bioinformatics analysis and quantitative real time polymerase chain reaction (qRT-PCR) validation of the sequencing data were performed. A network of circRNA-miRNA (microRNA)-mRNA was then constructed according to predicted targets and function of candidate circRNAs. Results A total of 11,685 annotated circRNAs were identified in six cervical samples. There were 42 up-regulated and 98 down-regulated circRNAs. 215 circRNAs were up-regulated in SCC but down-regulated circRNAs in ADC, while 50 circRNAs displayed the opposite trend. Function enrichment analysis based on different expressions of circRNAs found that the most enriched pathway in all the three pathologic variants of cervical cancer was the "ubiquitin mediated proteolysis" pathway. Eight key candidate circRNAs derived from this pathway were further validated, and we noticed that several target miRNAs of candidate circRNAs could target the source genes. Based on this we constructed a related competing endogenous RNA (ceRNA) network. Conclusion Through a comprehensive interpretation of differentially expressed circRNAs in different pathologic variants of cervical cancer, this study provides new insights into the process of tumor differentiation mediated by HPV. Our results may help to complement the molecular typing and stem cell theory of cervical cancer.
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Affiliation(s)
- Hongxue Luo
- Department of Gynecology and Obstetrics, Peking University People’Hospital, Peking University, Beijing, China
| | - Yi Zhu
- Department of Gynecology and Obstetrics, Peking University People’Hospital, Peking University, Beijing, China
| | - Jiaqi Wang
- Department of Gynecology and Obstetrics, Peking University People’Hospital, Peking University, Beijing, China
| | - Yue Wang
- Department of Gynecology and Obstetrics, Peking University People’Hospital, Peking University, Beijing, China
| | - Lihui Wei
- Department of Gynecology and Obstetrics, Peking University People’Hospital, Peking University, Beijing, China
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Wang C, Bai R, Liu Y, Wang K, Wang Y, Yang J, Cai H, Yang P. Multi-region sequencing depicts intratumor heterogeneity and clonal evolution in cervical cancer. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2023; 40:78. [PMID: 36635412 DOI: 10.1007/s12032-022-01942-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/24/2022] [Indexed: 01/13/2023]
Abstract
Cervical cancer is a heterogeneous malignancy mainly caused by human papillomavirus (HPV). While a few studies have revealed heterogeneity of cervical cancer in chromosome levels, the correlation between genetic heterogeneity and HPV integration in cervical cancer remains unknown. Here, we applied multi-region whole-exome sequencing and HPV integration analysis to explore intratumor heterogeneity in cervical cancer. We sequenced 20 tumor regions and 5 adjacent normal tissues from 5 cervical cancer patients, analysis based on somatic mutations and somatic copy number alterations (SCNAs) levels were performed. Variable heterogeneity was observed between the five patients with different tumor stages and HPV infection statuses. We found HPV integration has a positive effect on somatic mutation burden, but the relation to SCNAs remains unclear. Frequently mutated genes in cervical cancer were identified as trunk events, such as FBXW7, PIK3CA, FAT1 in somatic mutations and TP63, MECOM, PIK3CA, TBL1XR1 in SCNAs. New potential driver genes in cervical cancer were summarized including POU2F2, TCF7 and UBE2A. The SCNAs level has potential relation with tumor stage, and Signature 3 related to homologous recombination deficiency may be the appropriate biomarker in advanced cervical cancer. Mutation signature analysis also revealed a potential pattern that APOBEC-associated signature occurs in early stage and signatures associated with DNA damage repair arise at the later stage of cervical cancer evolution. In a conclusion, our study provides insights into the potential relationship between HPV infection and tumor heterogeneity. Those results enhanced our understanding of tumorigenesis and progression in cervical cancer.
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Affiliation(s)
- Chen Wang
- Key Laboratory of Bio-Resources and Eco-Environment, Center of Growth, Metabolism, and Aging, College of Life Sciences, Sichuan University, Chengdu, 610064, China
| | - Rui Bai
- Department of Obstetrics and Gynecology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832008, China
| | - Yu Liu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832008, China
| | - Kun Wang
- Key Laboratory of Bio-Resources and Eco-Environment, Center of Growth, Metabolism, and Aging, College of Life Sciences, Sichuan University, Chengdu, 610064, China
| | - Yu Wang
- Key Laboratory of Bio-Resources and Eco-Environment, Center of Growth, Metabolism, and Aging, College of Life Sciences, Sichuan University, Chengdu, 610064, China
| | - Jian Yang
- Key Laboratory of Bio-Resources and Eco-Environment, Center of Growth, Metabolism, and Aging, College of Life Sciences, Sichuan University, Chengdu, 610064, China
| | - Haoyang Cai
- Key Laboratory of Bio-Resources and Eco-Environment, Center of Growth, Metabolism, and Aging, College of Life Sciences, Sichuan University, Chengdu, 610064, China.
| | - Ping Yang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, 832008, China.
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Gamboa-Hoil SI. Human papillomavirus in men. Rev Int Androl 2023; 21:100325. [PMID: 36257902 DOI: 10.1016/j.androl.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/11/2021] [Accepted: 09/19/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To describe the clinical behavior of human papillomavirus in men. MATERIALS AND METHODS Current international literature was reviewed to describe the clinical behavior of human papillomavirus in men. RESULTS Internationally, the overall prevalence of HPV DNA is 50.8%, HPV considered high risk are 14 types. Prevalence of HPV DNA in invasive penile cancer ranges from 33.1% to 47%. HPV-16 has been the most frequent (68.3%), followed by HPV-6 (8.1%) and HPV-18 (6.9%). Positive HPV is described as an independent prognostic factor for cancer-specific survival. CONCLUSION It is not clear why HPV infection has a predilection in specific areas of the genital tract. However, it is important to note that there are factors that increase the risk of HPV infection.
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Xiong S, Lazovich DA, Hassan F, Ambo N, Ghebre R, Kulasingam S, Mason SM, Pratt RJ. Health care personnel's perspectives on human papillomavirus (HPV) self-sampling for cervical cancer screening: a pre-implementation, qualitative study. Implement Sci Commun 2022; 3:130. [PMID: 36514133 PMCID: PMC9745769 DOI: 10.1186/s43058-022-00382-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Persistent infection with high-risk human papillomavirus (hrHPV) types is a well-documented cause of cervical cancer. Since the implementation of cervical cancer screening methods (e.g., Pap tests), cervical cancer rates have declined. However, Pap tests are still unacceptable to many women and require complex infrastructure and training. Self-sampling techniques for collecting HPV specimens (or "HPV self-sampling") have been proposed as a possible alternative to overcome these barriers. The objective of this study was to capture perspectives from health care personnel (providers, leaders, and clinic staff) across primary care systems on the potential implementation of an HPV self-sampling practice. METHODS Between May and July 2021, a study invitation was emailed to various health care professional networks across the Midwest, including a snowball sampling of these networks. Eligible participants were invited to a 45-60-min Zoom-recorded interview session and asked to complete a pre-interview survey. The survey collected sociodemographics on age, occupation, level of educational attainment, race/ethnicity, gender, and awareness of HPV self-sampling. The semi-structured interview was guided by the Consolidated Framework for Implementation Research and asked participants about their views on HPV self-sampling and its potential implementation. All interviews were audio-recorded, transcribed, and analyzed using NVivo 12. RESULTS Key informant interviews were conducted with thirty health care personnel-13 health care providers, 6 clinic staff, and 11 health care leaders-from various health care systems. Most participants had not heard of HPV self-sampling but reported a general enthusiasm for wanting to implement it as an alternative cervical cancer screening tool. Possible barriers to implementation were knowledge of clinical evidence and ease of integration into existing clinic workflows. Potential facilitators included the previous adoption of similar self-sampling tools (e.g., stool-based testing kits) and key decision-makers. CONCLUSION Although support for HPV self-sampling is growing, its intervention's characteristics (e.g., advantages, adaptability) and the evidence of its clinical efficacy and feasibility need to be better disseminated across US primary care settings and its potential adopters. Future research is also needed to support the integration of HPV self-sampling within various delivery modalities (mail-based vs. clinic-based).
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Affiliation(s)
- Serena Xiong
- grid.4367.60000 0001 2355 7002Department of Surgery, Washington University School of Medicine, 600 S Taylor Avenue, St. Louis, MO 63110 USA
| | - De Ann Lazovich
- grid.17635.360000000419368657Department of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd Suite 300, Minneapolis, MN 55454 USA ,grid.17635.360000000419368657Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455 USA
| | - Faiza Hassan
- grid.17635.360000000419368657Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414 USA
| | - Nafisa Ambo
- grid.17635.360000000419368657Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414 USA
| | - Rahel Ghebre
- grid.17635.360000000419368657Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota Medical School, 420 Delaware St SE, Minneapolis, MN 55455 USA
| | - Shalini Kulasingam
- grid.17635.360000000419368657Department of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd Suite 300, Minneapolis, MN 55454 USA ,grid.17635.360000000419368657Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455 USA
| | - Susan M. Mason
- grid.17635.360000000419368657Department of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 S 2nd Suite 300, Minneapolis, MN 55454 USA
| | - Rebekah J. Pratt
- grid.17635.360000000419368657Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455 USA ,grid.17635.360000000419368657Program in Health Disparities Research, University of Minnesota Medical School, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414 USA
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High-Risk Human Papillomavirus Detection via Cobas ® 4800 and REBA HPV-ID ® Assays. Viruses 2022; 14:v14122713. [PMID: 36560717 PMCID: PMC9782071 DOI: 10.3390/v14122713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 12/09/2022] Open
Abstract
Persistent infection with high-risk human papillomaviruses (HR-HPVs), particularly HPV16 and 18, has long been known to induce cervical cancer progression. However, given that a minority of HPV-infected women develop cancer, analysis of HR-HPV-infected women could help to predict who is at risk of acquiring cervical cancer. Therefore, to improve HR-HPVs detection, we used the FDA-approved cobas® 4800 HPV and REBA HPV-ID® HPV assays to detect HR-HPVs in colposcopy-derived cervical cells from 303 patients, detecting 72.28% (219) and 71.62% (217) of HR-HPVs positive cases, with HPV16 detection rates of 35.64% (108) and 30.69% (93), respectively. Of the HPV16-positive cases, cobas® 4800 and REBA HPV-ID® identified 28.81% (51) and 25.42% (45) of the CIN1 cases, and 55% (33) and 50% (30) of the 60 CIN2/3 cases, respectively. HPV-diagnostic concordance was 82.17% overall (kappa = 0.488), 87.45% for HR-HPVs (kappa = 0.689), and 88.33% for CIN2/3 (kappa = 0.51). The HR-HPVs detection rates of these assays were comparable. Our findings reveal that the FDA-approved HR-HPVs detection assay is appropriate for screening women with HR-HPVs infection, and for predicting increased risk of cervical cancer progression. REBA HPV-ID® can be used to detect low risk-HPV types in high-grade cervical lesions that are HR-HPV negative as well as in the distribution of HPV types.
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Harnessing the Potential of Plant Expression System towards the Production of Vaccines for the Prevention of Human Papillomavirus and Cervical Cancer. Vaccines (Basel) 2022; 10:vaccines10122064. [PMID: 36560473 PMCID: PMC9782824 DOI: 10.3390/vaccines10122064] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Cervical cancer is the most common gynecological malignant tumor worldwide, and it remains a major health problem among women, especially in developing countries. Despite the significant research efforts employed for tumor prevention, cervical cancer ranks as the leading cause of cancer death. Human papillomavirus (HPV) is the most important risk factor for cervical cancer. Cervical cancer is a preventable disease, for which early detection could increase survival rates. Immunotherapies represent a promising approach in the treatment of cancer, and several potential candidates are in clinical trials, while some are available in the market. However, equal access to available HPV vaccines is limited due to their high cost, which remains a global challenge for cervical cancer prevention. The implementation of screening programs, disease control systems, and medical advancement in developed countries reduce the serious complications associated with the disease somewhat; however, the incidence and prevalence of cervical cancer in low-income and middle-income countries continues to gradually increase, making it the leading cause of mortality, largely due to the unaffordable and inaccessible anti-cancer therapeutic options. In recent years, plants have been considered as a cost-effective production system for the development of vaccines, therapeutics, and other biopharmaceuticals. Several proof-of-concept studies showed the possibility of producing recombinant biopharmaceuticals for cancer immunotherapy in a plant platform. This review summarizes the current knowledge and therapeutic options for the prevention of cervical cancer and discusses the potential of the plant expression platform to produce affordable HPV vaccines.
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Chen X, Chen C, Liu L, Dai W, Zhang J, Han C, Zhou S. Evaluation of p16/Ki-67 dual-stain as triage test for high-risk HPV-positive women: A hospital-based cross-sectional study. Cancer Cytopathol 2022; 130:955-963. [PMID: 35852302 DOI: 10.1002/cncy.22628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 06/28/2022] [Accepted: 06/29/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Most human papillomavirus (HPV)-positive women recover from infections and do not develop cervical intraepithelial neoplasia (CIN) and cervical cancer. Additional triage approaches are needed to reduce unnecessary colposcopy referrals. The aim of this study is to determine the high-risk HPV prevalence in a hospital-based population and to evaluate the performance of p16/Ki-67 dual-stain test for the triage of high-risk HPV-positive women to detect precursor lesions and cervical cancer compared with the ThinPrep cytologic test (TCT). METHODS In a hospital-based population, 100,801 women were provided with a primary HPV DNA test and only women with high-risk HPV infections were triaged using TCT and p16/Ki-67 dual-stain test. CIN2 or worse (≥CIN2) or CIN3 or worse (≥CIN3) were defined as the clinical end points. RESULTS The p16/Ki-67 dual-stain indicated a statistically significant higher sensitivity (82.8% vs. 66.7%%), specificity (51.6% vs. 44.4%), positive predictive value (33.2% vs. 25.8%), negative predictive value (91.2% vs. 82.1%), and accuracy (58.6% vs. 49.4%) compared with TCT examination within ≥CIN2 cases. Similar patterns were observed for the ≥CIN3 end point. CONCLUSIONS Our study demonstrated that p16/Ki-67 dual-stain test could achieve better performance compared with TCT examination for ≥CIN2 or ≥ CIN3 detection, representing a promising approach as a specific and efficient triage strategy for high-risk HPV-positive women.
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Affiliation(s)
| | - Chen Chen
- Yaneng Bioscience, Co, Ltd, Shenzhen, China
| | - Liyi Liu
- Department of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Wenjun Dai
- Yaneng Bioscience, Co, Ltd, Shenzhen, China
| | - Jing Zhang
- Department of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Chunyan Han
- Department of Clinical Laboratory, Shenzhen Nanshan Maternity and Child Healthcare Hospital, Shenzhen, China
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Rodriguez AM, Do TQN, Chen L, Schmeler KM, Montealegre JR, Kuo YF. Human papillomavirus vaccinations at recommended ages: How a middle school-based educational and vaccination program increased uptake in the Rio Grande Valley. Hum Vaccin Immunother 2022; 18:2133315. [PMID: 36252275 PMCID: PMC9746445 DOI: 10.1080/21645515.2022.2133315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/20/2022] [Accepted: 10/04/2022] [Indexed: 12/15/2022] Open
Abstract
Human papillomavirus (HPV) vaccination is recommended for U.S. adolescents at ages 11-12 requiring two or three doses depending on if the vaccine series started before age 15. The objective was to compare HPV vaccination rates among medically underserved, economically disadvantaged, students in rural middle school districts (Rio Grande Valley [RGV], Texas) by age of initiation (≤ age 11 years vs. age 12 years and older). This quasi-experimental study included 1,766 students (884 females; 882 males) who received at least one HPV vaccine dose through our school-based vaccination program between 08/2016-06/2022. Summary statistics were stratified by age at initiation and gender. The overall HPV up-to-date (UTD) rate was 59.7% (95% Confidence Interval: 57.4-62.0%). The median age at HPV UTD (range) was 12 years (9-19) and median interval between HPV vaccine doses (range) was 316 days (150-2,855). Most students received the HPV vaccine bundled with other vaccinations (72.4%, 1,279/1,766). There was a higher HPV UTD rate among students who initiated the HPV vaccine on or before age 11 than those who initiated on or after age 12 (73.6% versus 45.1%, respectively). The median age of HPV UTD was age 12 for those initiating on or before 11 years versus age 13 for those initiating on or after 12 years of age. Initiating the HPV vaccine at age ≤11 years increased completion of the HPV vaccine series. Improving HPV vaccine coverage and introduction of pan-gender vaccination programs will significantly decrease HPV-related diseases in the RGV.
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Affiliation(s)
- Ana M. Rodriguez
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, TX, USA
| | - Thuy Quynh N. Do
- Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Lu Chen
- Office of Biostatistics, Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
| | - Kathleen M. Schmeler
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jane R. Montealegre
- School of Health Professions, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Yong-Fang Kuo
- Office of Biostatistics, Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA
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Campos PL, Guimarães ICCDV, Fialho SCAV, Martins CAO, Rodrigues FR, Velarde LGC, Monteiro DDSA. Association of Swede Score and 2011 IFCPC Nomenclature in Women with Abnormal Cytology. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:938-944. [PMID: 36446560 PMCID: PMC9708394 DOI: 10.1055/s-0042-1751074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To assess the association between two colposcopic indices, the Swede score and the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) Nomenclature as well as to determine the efficacy of the Swede score with cutoffs of 7 and 8. METHODS In the present cross-sectional pilot study, 34 women who had at least 1 colposcopy-directed biopsy due to abnormal cytology were enrolled. The colposcopic findings were scored by both the Swede score and the 2011 IFCPC Nomenclature and were compared with each other. The Kappa coefficient and the McNemar test were used. Accuracy, sensitivity, specificity, and positive and negative predictive values (NPV and PPV, respectively) were calculated, as well as the effectiveness with cutoffs of 7 and 8 in identifying cervical intraepithelial neoplasm (CIN) 2+ when using the Swede score. RESULTS The correlation between the 2 colposcopic indices was 79.41%. The Kappa coefficient and the McNemar p-value were 0.55 and 0.37, respectively. The IFCPC Nomenclature had sensitivity, specificity, accuracy, PPV, and NPV of 85.71, 55.00, 67.64, 57.14, and 84.61%, respectively. The Swede score had sensitivity, specificity, accuracy, PPV, and NPV of 100, 63.15, 79.41, 68.18, and 100%, respectively. A Swede score cutoff of 7 for CIN 2+ detection had a specificity of 94.73%, while with a cutoff of 8 it increased to 100%. The sensitivity for both values was 60%. The PPV and NPV for cutoffs of 7 and 8 were 90 and 75 and 100 and 76%, respectively. CONCLUSION Although both colposcopic indices have good reproducibility, the Swede score showed greater accuracy, sensitivity, and specificity in identifying CIN 2 + , especially when using a cutoff of 8.
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Affiliation(s)
- Priscila Loyola Campos
- Universidade Federal Fluminense, Maternal – Infant Department Niterói, RJ, Brasil,Address for correspondence Priscila Loyola Campos, MSc Rua Marques do Paraná303, Niterói 24033-900, Rio de JaneiroBrasil
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Rol ML, Picconi MA, Ferrera A, Sánchez GI, Hernández MDLL, Lineros J, Peraza A, Brizuela M, Mendoza L, Mongelós P, Cabrera Y, Rodríguez de la Peña M, Correa RM, Terán C, Colque Reynaga D, García L, Ramírez AT, Hernández-Nevarez P, Doimi F, Ramón M, Arias-Stella J, Zúñiga M, Villagra V, Bobadilla ML, Cardinal L, Valls J, Lucas E, Baena A, Fleider L, Venegas G, Cruz-Valdez A, Rodríguez G, Calderón A, Wiesner C, Luciani S, Broutet N, Herrero R, Almonte M. Implementing HPV testing in 9 Latin American countries: The laboratory perspective as observed in the ESTAMPA study. Front Med (Lausanne) 2022; 9:1006038. [PMID: 36465901 PMCID: PMC9714610 DOI: 10.3389/fmed.2022.1006038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Replacement of cytology screening with HPV testing is recommended and essential for cervical cancer elimination. HPV testing for primary screening was implemented in 12 laboratories within 9 Latin American countries, as part of the ESTAMPA cervical cancer screening study. Our observations provide information on critical operational aspects for HPV testing implementation in diverse resource settings. Methods We describe the implementation process of HPV testing in ESTAMPA, focusing on laboratory aspects. We assess the readiness of 12 laboratories to start HPV testing and their continuity capacity to maintain good quality HPV testing until end of recruitment or up to December 2021. Readiness was based on a checklist. Information from the study database; regular meetings and monitoring visits; and a questionnaire on laboratory operational aspects sent in May 2020 were used to assess continuity capacity. Compliance with seven basic requirements (readiness) and eight continuity requirements (continuity capacity) was scored (1 = compliant, 0 = not compliant) and totaled to classify readiness and continuity capacity as very limited, limited, moderate or high. Experiences, challenges, and enablers of the implementation process are also described. Results Seven of 12 laboratories had high readiness, three moderate readiness, and of two laboratories new to HPV testing, one had limited readiness and the other very limited readiness. Two of seven laboratories with high readiness also showed high continuity capacity, one moderate continuity capacity, and the other four showed limited continuity capacity since they could not maintain good quality HPV testing over time. Among three laboratories with moderate readiness, one kept moderate continuity capacity and two reached high continuity capacity. The two laboratories new to HPV testing achieved high continuity capacity. Based on gained expertise, five laboratories have become part of national screening programs. Conclusion High readiness of laboratories is an essential part of effective implementation of HPV testing. However, high readiness is insufficient to guarantee HPV testing high continuity capacity, for which a "culture of quality" should be established with regular training, robust monitoring and quality assurance systems tailored to local context. All efforts to strengthen HPV laboratories are valuable and crucial to guarantee effective implementation of HPV-based cervical screening.
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Affiliation(s)
- Mary Luz Rol
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Annabelle Ferrera
- Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | | | - María de la Luz Hernández
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
- SMS-Oncology, Amsterdam, Netherlands
| | - Joana Lineros
- Instituto Nacional de Cancerología, Bogotá, Colombia
| | - Ana Peraza
- Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San José, Costa Rica
| | - Marisol Brizuela
- Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San José, Costa Rica
| | - Laura Mendoza
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Pamela Mongelós
- Instituto de Investigaciones en Ciencias de la Salud, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - Yessy Cabrera
- Grupo de Infección y Cáncer, Universidad de Antioquia, Medellín, Colombia
| | | | - Rita Mariel Correa
- Instituto de Investigaciones en Microbiología, Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras
| | - Carolina Terán
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Deisy Colque Reynaga
- Facultad de Medicina, Universidad Mayor, Real y Pontificia de San Francisco Xavier de Chuquisaca, Sucre, Bolivia
| | - Laura García
- Laboratorio de Biología Molecular, Departamento de Patología Clínica, Centro Hospitalario Pereira Rossell, Montevideo, Uruguay
| | - Arianis Tatiana Ramírez
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Franco Doimi
- Laboratorio de Patología Oncológica SAC, Lima, Peru
| | - María Ramón
- Laboratorio de Patología Oncológica SAC, Lima, Peru
| | | | - Michael Zúñiga
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, San José, Guanacaste, Costa Rica
| | | | | | - Lucía Cardinal
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - Joan Valls
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Eric Lucas
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Armando Baena
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
| | - Laura Fleider
- Hospital de Clínicas José de San Martín, Buenos Aires, Argentina
| | - Gino Venegas
- Clínica Angloamericana, Lima, Peru
- Liga contra el Cáncer, Lima, Peru
| | | | | | - Alejandro Calderón
- Caja Costarricense de Seguro Social (CCSS), Región Pacífico Central, San José, Costa Rica
| | | | - Silvana Luciani
- Pan American Health Organization (PAHO), Washington, DC, United States
| | - Nathalie Broutet
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Rolando Herrero
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), Fundación Inciensa, San José, Guanacaste, Costa Rica
| | - Maribel Almonte
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Single-cell transcriptomics reveals cellular heterogeneity and molecular stratification of cervical cancer. Commun Biol 2022; 5:1208. [DOI: 10.1038/s42003-022-04142-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022] Open
Abstract
AbstractCervical cancer (CC) is the most common gynecological malignancy, whose cellular heterogeneity has not been fully understood. Here, we performed single-cell RNA sequencing (scRNA-seq) to survey the transcriptomes of 57,669 cells derived from three CC tumors with paired normal adjacent non-tumor (NAT) samples. Single-cell transcriptomics analysis revealed extensive heterogeneity in malignant cells of human CCs, wherein epithelial subpopulation exhibited different genomic and transcriptomic signatures. We also identified cancer-associated fibroblasts (CAFs) that may promote tumor progression of CC, and further distinguished inflammatory CAF (iCAF) and myofibroblastic CAF (myCAF). CD8+ T cell diversity revealed both proliferative (MKI67+) and non-cycling exhausted (PDCD1+) subpopulations at the end of the trajectory path. We used the epithelial signature genes derived from scRNA-seq to deconvolute bulk RNA-seq data of CC, identifying four different CC subtypes, namely hypoxia (S-H subtype), proliferation (S-P subtype), differentiation (S-D subtype), and immunoactive (S-I subtype) subtype. The S-H subtype showed the worst prognosis, while CC patients of the S-I subtype had the longest overall survival time. Our results lay the foundation for precision prognostic and therapeutic stratification of CC.
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Luo A, Lan X, Qiu Q, Zhou Q, Li J, Wu M, Liu P, Zhang H, Lu B, Lu Y, Lu W. LncRNA SFTA1P promotes cervical cancer progression by interaction with PTBP1 to facilitate TPM4 mRNA degradation. Cell Death Dis 2022; 13:936. [PMID: 36344495 PMCID: PMC9640654 DOI: 10.1038/s41419-022-05359-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022]
Abstract
Long non-coding RNAs (lncRNAs) play key roles in cancer development and progression. However, the biological function and clinical significance of most lncRNAs in cervical cancer remain elusive. In this study, we explore the function and mechanism of lncRNA surfactant associated 1 (SFTA1P) in cervical cancer. We firstly identified SFTA1P by analyzing the RNA sequencing data of cervical cancer from our previous study and from The Cancer Genome Atlas (TCGA). We then verified SFTA1P expression by qRT-PCR. The cell proliferation and migration capacity of SFTA1P was assessed by using CCK-8, colony formation, transwell and wound healing assays. RNA pull-down, RNA immunoprecipitation (RIP), RNA stability and western blot assays were used to reveal potential mechanisms. Athymic nude mice were used to evaluate tumorigenicity and metastasis in vivo. SFTA1P is upregulated in cervical tumor tissues and its high expression is associated with poor prognosis. Biologically, knockdown of SFTA1P inhibited the proliferation, migration, and invasion of cervical cancer cells in vitro, as well as tumorigenesis and metastasis in vivo. Mechanistically, SFTA1P was shown to interact with polypyrimidine tract binding protein 1 (PTBP1) to regulate the stability of tropomyosin 4 (TPM4) mRNA, thereby resulting in malignant cell phenotypes. TPM4 knockdown could attenuate the suppression of cell progression induced by either SFTA1P or PTBP1 knockdown. Our findings demonstrate that SFTA1P can promote tumor progression by mediating the degradation of TPM4 mRNA through its interaction with PTBP1 protein. This provides a potential therapeutic strategy to target the SFTA1P-PTBP1-TPM4 axis in cervical cancer.
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Affiliation(s)
- Aoran Luo
- grid.13402.340000 0004 1759 700XZhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women’s Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang China
| | - Xiaoxiao Lan
- grid.13402.340000 0004 1759 700XWomen’s Reproductive Health Key Laboratory of Zhejiang Province and Department of Gynecologic Oncology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang China
| | - Qiongzi Qiu
- grid.13402.340000 0004 1759 700XZhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women’s Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang China
| | - Qing Zhou
- grid.13402.340000 0004 1759 700XZhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women’s Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang China
| | - Jia Li
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Medicine, Sir Run Run Shaw Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310016 Zhejiang China
| | - Mengting Wu
- grid.13402.340000 0004 1759 700XZhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women’s Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang China
| | - Pengyuan Liu
- grid.13402.340000 0004 1759 700XDepartment of Respiratory Medicine, Sir Run Run Shaw Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310016 Zhejiang China ,grid.13402.340000 0004 1759 700XCancer Center, Zhejiang University, Hangzhou, 310013 Zhejiang China
| | - Honghe Zhang
- grid.13402.340000 0004 1759 700XCancer Center, Zhejiang University, Hangzhou, 310013 Zhejiang China ,grid.13402.340000 0004 1759 700XDepartment of Pathology, Research Unit of Intelligence Classification of Tumor Pathology and Precision Therapy, Chinese Academy of Medical Sciences, Zhejiang University School of Medicine, Hangzhou, 310058 Zhejiang China
| | - Bingjian Lu
- grid.13402.340000 0004 1759 700XZhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women’s Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang China
| | - Yan Lu
- grid.13402.340000 0004 1759 700XZhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Women’s Hospital and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang China ,grid.13402.340000 0004 1759 700XCancer Center, Zhejiang University, Hangzhou, 310013 Zhejiang China
| | - Weiguo Lu
- grid.13402.340000 0004 1759 700XWomen’s Reproductive Health Key Laboratory of Zhejiang Province and Department of Gynecologic Oncology, Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310006 Zhejiang China ,grid.13402.340000 0004 1759 700XCancer Center, Zhejiang University, Hangzhou, 310013 Zhejiang China
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Burger EA, de Kok IMCM, O'Mahony JF, Rebolj M, Jansen EEL, de Bondt DD, Killen J, Hanley SJ, Castanon A, Regan MC, Kim JJ, Canfell K, Smith MA. A model-based analysis of the health impacts of COVID-19 disruptions to primary cervical screening by time since last screen for current and future disruptions. eLife 2022; 11:e81711. [PMID: 36222673 PMCID: PMC9555861 DOI: 10.7554/elife.81711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022] Open
Abstract
We evaluated how temporary disruptions to primary cervical cancer (CC) screening services may differentially impact women due to heterogeneity in their screening history and test modality. We used three CC models to project the short- and long-term health impacts assuming an underlying primary screening frequency (i.e., 1, 3, 5, or 10 yearly) under three alternative COVID-19-related screening disruption scenarios (i.e., 1-, 2-, or 5-year delay) versus no delay in the context of both cytology-based and human papillomavirus (HPV)-based screening. Models projected a relative increase in symptomatically detected cancer cases during a 1-year delay period that was 38% higher (Policy1-Cervix), 80% higher (Harvard), and 170% higher (MISCAN-Cervix) for underscreened women whose last cytology screen was 5 years prior to the disruption period compared with guidelines-compliant women (i.e., last screen 3 years prior to disruption). Over a woman's lifetime, temporary COVID-19-related delays had less impact on lifetime risk of developing CC than screening frequency and test modality; however, CC risks increased disproportionately the longer time had elapsed since a woman's last screen at the time of the disruption. Excess risks for a given delay period were generally lower for HPV-based screeners than for cytology-based screeners. Our independent models predicted that the main drivers of CC risk were screening frequency and screening modality, and the overall impact of disruptions from the pandemic on CC outcomes may be small. However, screening disruptions disproportionately affect underscreened women, underpinning the importance of reaching such women as a critical area of focus, regardless of temporary disruptions.
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Affiliation(s)
- Emily A Burger
- Center for Health Decision Science, Harvard T.H. Chan School of Public HealthBostonUnited States
- Department of Health Management and Health Economics, University of OsloOsloNorway
| | - Inge MCM de Kok
- Department of Public Health, Erasmus MC, University Medical Center RotterdamRotterdamNetherlands
| | - James F O'Mahony
- Centre for Health Policy & Management, School of Medicine, Trinity College DublinDublinIreland
| | - Matejka Rebolj
- Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King’s College LondonLondonUnited Kingdom
| | - Erik EL Jansen
- Department of Public Health, Erasmus MC, University Medical Center RotterdamRotterdamNetherlands
| | - Daniel D de Bondt
- Department of Public Health, Erasmus MC, University Medical Center RotterdamRotterdamNetherlands
| | - James Killen
- Cancer Research Division, Cancer Council NSWSydneyAustralia
| | - Sharon J Hanley
- Hokkaido University Center for Environmental and Health SciencesSapporoJapan
| | - Alejandra Castanon
- Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, King’s College LondonLondonUnited Kingdom
| | - Mary Caroline Regan
- Center for Health Decision Science, Harvard T.H. Chan School of Public HealthBostonUnited States
| | - Jane J Kim
- Center for Health Decision Science, Harvard T.H. Chan School of Public HealthBostonUnited States
| | - Karen Canfell
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSWSydneyAustralia
| | - Megan A Smith
- Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSWSydneyAustralia
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Wei Z, Gan J, Feng X, Zhang M, Chen Z, Zhao H, Du Y. APOBEC3B is overexpressed in cervical cancer and promotes the proliferation of cervical cancer cells through apoptosis, cell cycle, and p53 pathway. Front Oncol 2022; 12:864889. [PMID: 36249021 PMCID: PMC9556651 DOI: 10.3389/fonc.2022.864889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 09/09/2022] [Indexed: 12/24/2022] Open
Abstract
Objective APOBEC3B (A3B), a member of the APOBEC family of cytidine deaminases, has been gradually regarded as a key cancerous regulator. However, its expression and mechanism in cervical cancer (CC) have not been fully elucidated. This study was to investigate its expression pattern and potential mechanism on the cell cycle, as well as HPV oncogenes in CC. Methods Data from The Cancer Genome Atlas (TCGA) and Gene Expression (GEO) were used to indicate the mRNA expression pattern of A3B in cervical cancer. Western blot assay was used to detect A3B levels in SiHa and Hela cell lines. Immunohistochemistry (IHC) was used to explore A3B protein abundance and sublocation in cervical cancer as well as normal cervical tissues. Based on the Protein atlas (www.proteinatlas.org), A3B expression in the SiHa cell line is lower than in the HeLa cell line. Therefore, the SiHa cell line was used for A3B gene overexpression experiments while the HeLa cell line was used for knockdown experiments. Flow cytometry analysis was used to detect cell apoptosis. Biological function and cancer-related pathways of A3B were conducted using bioinformatics analysis. Results A3B mRNA was significantly overexpressed in cervical cancer in TCGA-cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC), GSE67522, and GSE7803. A3B was more highly expressed in cervical cancers than in high-grade squamous intraepithelial lesions and normal controls. A3B expression was found to be progressively activated during cervical cancer development. IHC results showed that A3B was significantly higher in cervical cancer tissues than in normal cervical tissues. A3B plasmid-mediated overexpression experiments and A3B siRNA-mediated knockdown experiments showed that A3B significantly promotes cell proliferation, migration, cell cycle, and chemoresistance in cervical cancer cells by the p53 pathway. GO and KEGG analyses showed that A3B expression was strikingly associated with cell proliferation, apoptosis, and immune-associated pathways. Conclusions Taken together, our study implies that A3B promotes cell proliferation, migration, and cell cycle and inhibits cancer cell apoptosis through the p53-mediated signaling pathway. Moreover, A3B could also contribute to chemoresistance in cervical cancer cells. It may be a potential diagnostic biomarker and therapeutic target for chemoresistant cervical cancers.
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Affiliation(s)
- Zhi Wei
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai, China
| | - Jianfeng Gan
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai, China
| | - Xuan Feng
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai, China
| | - Mo Zhang
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai, China
- Institutes of Integrative Medicine, Fudan University, Shanghai, China
| | - Zhixian Chen
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai, China
| | - Hongbo Zhao
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai, China
- *Correspondence: Yan Du, ; Hongbo Zhao,
| | - Yan Du
- Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Department of Obstetrics and Gynecology of Shanghai Medical School, Fudan University, Shanghai, China
- Institutes of Integrative Medicine, Fudan University, Shanghai, China
- *Correspondence: Yan Du, ; Hongbo Zhao,
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Chao CR, Chubak J, Beaber EF, Kamineni A, Mao C, Silverberg MJ, Tiro JA, Skinner C, Garcia M, Corley DA, Winer RL, Raine‐Bennett T, Feldman S, Wheeler CM. Gaps in the screening process for women diagnosed with cervical cancer in four diverse US health care settings. Cancer Med 2022; 12:3705-3717. [PMID: 36106421 PMCID: PMC9939213 DOI: 10.1002/cam4.5226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/18/2022] [Accepted: 08/24/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Potential care gaps in the cervical cancer screening process among women diagnosed with cervical cancer in an era with increased human papillomavirus (HPV) testing have not been extensively evaluated. METHODS Women diagnosed with cervical cancer between ages 21 and 65 at four study sites between 2010 and 2014 were included. Screening histories were ascertained from 0.5 to 4 years prior to cervical cancer diagnosis. We identified potential care gaps in the screening history for each woman and classified them into one of three mutually exclusive types: lack of a screening test, screening test failure, and diagnostic/treatment care gap. Distributions of care gaps were tabulated by stage, histology, and study site. Multivariable nominal logistic regression was used to examine the associations between demographic and cancer characteristics and type of care gap. RESULTS Of 499 women evaluated, 46% lacked a screening test in the time window examined, 31% experienced a screening test failure, and 22% experienced a diagnostic/treatment care gap. More than half of the women with advanced cancer and squamous cell carcinoma lacked a screening test compared to 31% and 24% of women with localized cancer and adenocarcinoma, respectively. Women aged 21-29 at diagnosis were more likely to experience screening test failure and diagnostic/treatment care gap, while those aged 50-65 were more likely to lack a screening test, compared to women aged 30-39. CONCLUSIONS Our findings demonstrate a continuing need to develop interventions targeting unscreened and under-screened women and improve detection and diagnosis of adenocarcinoma in women undergoing cervical cancer screening and diagnostic follow-up.
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Affiliation(s)
- Chun R. Chao
- Department of Research and EvaluationKaiser Permanente Southern CaliforniaPasadenaCaliforniaUSA
| | - Jessica Chubak
- Kaiser Permanente Washington Health Research InstituteSeattleWashingtonUSA
| | - Elisabeth F. Beaber
- Fred Hutchinson Cancer Research Center, Public Health Sciences DivisionSeattleWashingtonUSA
| | - Aruna Kamineni
- Kaiser Permanente Washington Health Research InstituteSeattleWashingtonUSA
| | - Connie Mao
- Department of Obstetrics and Gynecology, University of WashingtonSeattleWashingtonUSA
| | | | - Jasmin A. Tiro
- Department of Population and Data SciencesUniversity of Texas Southwestern Medical CenterDallasTexasUSA,Harold C. Simmons Comprehensive Cancer CenterDallasTexasUSA
| | - Celette Skinner
- Department of Population and Data SciencesUniversity of Texas Southwestern Medical CenterDallasTexasUSA,Harold C. Simmons Comprehensive Cancer CenterDallasTexasUSA
| | - Michael Garcia
- Fred Hutchinson Cancer Research Center, Public Health Sciences DivisionSeattleWashingtonUSA
| | - Douglas A. Corley
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCaliforniaUSA
| | - Rachel L. Winer
- Department of EpidemiologyUniversity of Washington School of Public HealthSeattleWashingtonUSA
| | - Tina Raine‐Bennett
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCaliforniaUSA,Medicines360San FranciscoCaliforniaUSA
| | - Sarah Feldman
- Division of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Cosette M. Wheeler
- Center for HPV PreventionUniversity of New Mexico Comprehensive Cancer CenterAlbuquerqueNew MexicoUSA
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Wang J, Gu X, Cao L, Ouyang Y, Qi X, Wang Z, Wang J. A novel prognostic biomarker CD3G that correlates with the tumor microenvironment in cervical cancer. Front Oncol 2022; 12:979226. [PMID: 36176400 PMCID: PMC9513466 DOI: 10.3389/fonc.2022.979226] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/24/2022] [Indexed: 11/21/2022] Open
Abstract
Cervical cancer (CESC) is the fourth most common and death-causing gynecological cancer, mostly induced by infection of human papillomavirus (HPV). Multiple components of the tumor microenvironment (TME), such as tumor infiltrating immune cells, could be targets of immunotherapy for HPV-related CESC. However, little is known about the TME of CESC until now. Here, we aimed to uncover the pathogenesis as well as to identify novel biomarkers to predict prognosis and immunotherapy efficacy for CESC. Combining the transcriptomic data and clinical characteristics, we identified differentially expressed genes in CESC samples from TCGA database by comparing the two groups with different ImmuneScore and StromalScore. Next, we detected ten key genes based on the PPI network and survival analyses with the univariate Cox regression model. Thereafter, we focused on CD3G, the only gene exhibiting increased RNA and protein expression in tumors by multiple analyses. Higher CD3G expression was associated with better survival; and it was also significantly associated with immune-related pathways through GSEA analysis. Furthermore, we found that CD3G expression was correlated with 16 types of TICs. Single cell RNA-sequencing data of CD3G in lymphocytes subgroup indicated its possible role in HPV defense. Hence, CD3G might be a novel biomarker in prognosis and immunotherapy for CESC patients.
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Affiliation(s)
- Jingshuai Wang
- Department of Obstetrics and Gynecology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xuemin Gu
- Department of Obstetrics and Gynecology, Tongji Hospital of Tongji University, Shanghai, China
| | - Leilei Cao
- Department of Obstetrics and Gynecology, Shanghai Eighth People’s Hospital, Shanghai, China
| | - Yiqin Ouyang
- Department of Obstetrics and Gynecology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiao Qi
- Department of Obstetrics and Gynecology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Zhijie Wang
- Department of Obstetrics and Gynecology, Shanghai Eighth People’s Hospital, Shanghai, China
- *Correspondence: Jianjun Wang, ; Zhijie Wang,
| | - Jianjun Wang
- Department of Obstetrics and Gynecology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Jianjun Wang, ; Zhijie Wang,
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69
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Wittenborn J, Kupec T, Iborra S, Stickeler E, Najjari L, Kennes LN. HPV High-risk Multiple Infection Is a Key Predictor of Cervical Dysplasia in Diagnostic LEEPs: a Retrospective Cohort Analysis. Geburtshilfe Frauenheilkd 2022; 82:1387-1396. [PMID: 36467973 PMCID: PMC9713297 DOI: 10.1055/a-1857-6470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/19/2022] [Indexed: 10/15/2022] Open
Abstract
Objective This study aimed to identify predictors for the presence of cervical dysplasia in diagnostic LEEPs (Loop Electrical Excision Procedure) of the cervix. Materials/Methods The study was designed as a retrospective single-institution cohort analysis of all patients who underwent LEEP without prior proof of high-grade intraepithelial lesion (diagnostic LEEP) between 2015 and 2020 in the Department of Obstetrics and Gynecology of University Hospital Aachen. In order to identify the most meaningful predictive variables for CIN status (CIN2+ or non-CIN2+), multivariate logistic regression was performed and a machine-learning method was used. Results A total of 849 patients with an indication for loop excision of the cervix were assessed for eligibility. Finally, 125 patients without prior proof of CIN2+ were included into the study. Based on the final multivariate logistic regression model, multiple high-risk HPV infections (p = 0.001), the presence of a T2 transformation zone (p = 0.003) and major lesion changes (p = 0.015) as a result of the colposcopy examination were found to be statistically significant for CIN status based on the diagnostic LEEP. Subsequent ROC analysis showed a high predictive value for the model of 88.35% (AUC). The machine-learning technique (recursive partitioning) identified similar variables as important for CIN status with an accuracy of 75%. Conclusion For clinical decision-making, the result of the colposcopy examination (T2, major change) as well as the results of HPV testing (multiple high-risk HPV infections) are stronger indicators for clinicians to perform diagnostic excisional procedures of the cervix than the presence of high-grade cytological abnormalities.
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Affiliation(s)
- Julia Wittenborn
- 39058Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany,Korrespondenzadresse Dr. Julia Wittenborn 39058University Hospital Aachen, Department of Obstetrics and
GynecologyPauwelsstr. 3052074
AachenGermany
| | - Tomas Kupec
- 39058Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany
| | - Severine Iborra
- 39058Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany
| | - Elmar Stickeler
- 39058Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany
| | - Laila Najjari
- 39058Department of Obstetrics and Gynecology, University Hospital Aachen, Aachen, Germany
| | - Lieven N. Kennes
- 84592Department of Economics and Business Administration, University of Applied Sciences Stralsund, Stralsund, Germany
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70
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Jiang L, Li D, Wang C, Liao J, Liu J, Wei Q, Wang Y. Decreased Expression of Karyopherin-α 1 is Related to the Malignant Degree of Cervical Cancer and is Critical for the Proliferation of Hela Cells. Pathol Oncol Res 2022; 28:1610518. [PMID: 35991835 PMCID: PMC9385962 DOI: 10.3389/pore.2022.1610518] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022]
Abstract
Karyopherin α (KPNA) proteins are involved in nucleocytoplasmic trafficking and are critical for protein subcellular localization. Recent studies have suggested that KPNA proteins are abnormally expressed in various solid tumors. The objective of this study was to investigate the expression of KPNA1 and KPNA2 in cervical cancer tissue with different histologic grades and cell lines, as well as the effects of the KPNA1 expression level on Hela cell proliferation. We collected the medical data of 106 patients with cervical cancer and investigated the protein expression of KPNA1 and KPNA2 by immunohistochemistry and western blot. The results revealed a significantly lower expression of KPNA1 in cervical cancer compared to normal tissue. Conversely, stronger staining intensity for KPNA2 was observed in cervical tumor samples. The expression levels of KPNA1 and KPNA2 were significantly associated with the tumor histologic grade. The weakest KPNA1 expression and strongest staining for KPNA2 were observed in grade III tumor tissue. The expression levels of KPNA1 were lower in Hela and C33A cells compared with normal human cervical epithelial cells; however, the expression of KPNA2 exhibited an opposite trend. The up-regulation of KPNA1 significantly suppressed the proliferation of Hela cells and relevant proteins expression, as well as promoted transportation of IRF3 into nucleus. Our results suggest the downregulation of KPNA1 expression is related to the malignant degree of cervical cancer and is closely associated with the proliferation of cervical cancer cells.
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Affiliation(s)
- Lucen Jiang
- Department of Pathology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Dan Li
- Department of Pathology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Chao Wang
- Department of Pathology, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Jia Liao
- Department of Pathophysiology, School of Medicine, Jinan University, Guangzhou, China
| | - Jianghuan Liu
- Department of Pathology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Qingzhu Wei
- Department of Pathology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
- *Correspondence: Qingzhu Wei, ; Yiyang Wang,
| | - Yiyang Wang
- Department of Pathophysiology, School of Medicine, Jinan University, Guangzhou, China
- *Correspondence: Qingzhu Wei, ; Yiyang Wang,
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71
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Ma Y, Liang F, Zhu M, Chen C, Chen C, Lv X. FT-IR combined with PSO-CNN algorithm for rapid screening of cervical tumors. Photodiagnosis Photodyn Ther 2022; 39:103023. [PMID: 35868522 DOI: 10.1016/j.pdpdt.2022.103023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 01/11/2023]
Abstract
Cervical cancer is the most common gynecological malignancy with a slow onset. Early and accurate identification of the stage of cervical cancer patients can greatly improve the cure rate. In this study, serum sample data were collected from patients with cervical cancer, CIN (cervical intraepithelial neoplasia) I, CIN II, CIN III and hysteromyoma using FT-IR technology. PSO-CNN model for early screening of cervical cancer was designed using a particle swarm algorithm to automatically build a CNN structure with variable number of layers and variable layer class parameters. The experimental results showed that PSO-CNN was the best compared with the classical Lenet, AlexNet, VGG16 and GoogLeNet deep learning models, and the accuracy of PSO-CNN in discriminating five types of samples can reach 87.2%. This study showed that FT-IR technology combined with PSO-CNN model had great potential for non-invasive, rapid and accurate identification of patients with cervical cancer, and can provide a reference for intelligent diagnosis of other diseases.
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Affiliation(s)
- Yuhua Ma
- Department of Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China; Department of Pathology, Karamay central Hosptial of XinJiang Karamay, Karamay, Xinjiang Uygur Autonomous Region 834000, China
| | - Fei Liang
- Department of Pathology, Karamay central Hosptial of XinJiang Karamay, Karamay, Xinjiang Uygur Autonomous Region 834000, China
| | - Min Zhu
- College of Software, Xinjiang University, No. 448, Northwest Road, Shayibake District, Urumqi, Xinjiang 830046, China.
| | - Cheng Chen
- College of Software, Xinjiang University, No. 448, Northwest Road, Shayibake District, Urumqi, Xinjiang 830046, China.
| | - Chen Chen
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China; Xinjiang Cloud Computing Application Laboratory, Karamay 834099, China
| | - Xiaoyi Lv
- College of Software, Xinjiang University, No. 448, Northwest Road, Shayibake District, Urumqi, Xinjiang 830046, China
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The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review. BIOLOGY 2022; 11:biology11070956. [PMID: 36101337 PMCID: PMC9312145 DOI: 10.3390/biology11070956] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/11/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022]
Abstract
Human papillomaviruses (HPVs) are common sexually transmitted infectious agents responsible for several anogenital and head and neck cancers. Cervical cancer (CC) is the fourth leading cause of death in women with cancer. The progression of a persistent HPV infection to cancer takes 15–20 years and can be preventable through screening. Cervical cytology (Pap smear) is the standard screening test for CC and precancerous lesions. For ASC-US and ASC-H lesions, a combination of Pap smear and HR-HPV analysis is recommended as a triage step before colposcopy. However, these tests cannot predict progression to CC. For this purpose, we summarized current scientific data on the role of p16/Ki-67 immunohistostaining, telomerase and fibronectin in predicting progression to CC. p16 and p16/Ki-67 dual staining (DS) were more specific than HR-HPV DNA testing for the detection of CIN2+/CIN3+ in women with ASC-US and LSIL. Similarly, hTERC FISH analysis significantly improved the specificity and positive predictive value of HPV DNA testing in differentiating CIN2+ from CIN2 cytological samples. In conclusion, p16 IHC, p16/Ki-67 DS and hTERC FISH amplification are all valid adjunctive biomarkers which significantly increase the sensitivity and specificity of cervical dysplasia diagnosis, especially when combined with HPV DNA testing. However, considering the global socioeconomic background, we can postulate that p16 and p16/ Ki-67 IHC can be used as a next step after positive cytology for ASC-US or LSIL specimens in low-income countries, instead of HPV DNA testing. Alternatively, if HPV DNA testing is covered by insurance, p16 or p16/Ki-67 DS and HPV DNA co-testing can be performed. In middle- and high-income countries, hTERC amplification can be performed as an adjunctive test to HPV DNA testing in women with ASC-US and LSIL.
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73
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Macios A, Nowakowski A. False Negative Results in Cervical Cancer Screening-Risks, Reasons and Implications for Clinical Practice and Public Health. Diagnostics (Basel) 2022; 12:1508. [PMID: 35741319 PMCID: PMC9222017 DOI: 10.3390/diagnostics12061508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/06/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
False negative (FN) results in cervical cancer (CC) screening pose serious risks to women. We present a comprehensive literature review on the risks and reasons of obtaining the FN results of primary CC screening tests and triage methods and discuss their clinical and public health impact and implications. Misinterpretation or true lack of abnormalities on a slide are the reasons of FN results in cytology and p16/Ki-67 dual-staining. For high-risk human papillomavirus (HPV) molecular tests, those include: truly non-HPV-associated tumors, lesions driven by low-risk HPV types, and clearance of HPV genetic material before sampling. Imprecise disease threshold definition lead to FN results in visual inspection with acetic acid. Lesions with a discrete colposcopic appearance are a source of FN in colposcopic procedures. For FAM19A4 and hsa-miR124-2 genes methylation, those may originate from borderline methylation levels. Histological misinterpretation, sampling, and laboratory errors also play a role in all types of CC screening, as well as reproducibility issue, especially in methods based on human-eye evaluation. Primary HPV-based screening combined with high quality-assured immunocytochemical and molecular triage methods seem to be an optimal approach. Colposcopy with histological evaluation remains the gold standard for diagnosis but requires quality protocols and assurance measures.
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Affiliation(s)
- Anna Macios
- Doctoral School of Translational Medicine, Centre of Postgraduate Medical Education, Marymoncka Street 99/103, 01-813 Warsaw, Poland
- Department of Cancer Prevention, The Maria Sklodowska-Curie National Research Institute of Oncology, Roentgen Street 5, 02-781 Warsaw, Poland
| | - Andrzej Nowakowski
- Department of Cancer Prevention, The Maria Sklodowska-Curie National Research Institute of Oncology, Roentgen Street 5, 02-781 Warsaw, Poland
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74
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Poynten IM, Jin F, Molano M, Roberts JM, Hillman RJ, Templeton DJ, Law C, Stanley MA, Waterboer T, Farnsworth A, Fairley CK, Garland SM, Grulich AE. Possible Reactivation of Latent Anal Human Papillomavirus Associated with Markers of Immune Dysfunction in Gay and Bisexual Men. Cancer Epidemiol Biomarkers Prev 2022; 31:1052-1057. [PMID: 35244674 DOI: 10.1158/1055-9965.epi-21-1346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/16/2022] [Accepted: 02/18/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND It is unknown whether reactivation of human papillomavirus (HPV) after latency occurs in the anus. We measured incidence and predictors of incident anal HPV in sexually inactive gay and bisexual men (GBM) as a surrogate of HPV reactivation. METHODS The Study of the Prevention of Anal Cancer collected data on sexual behavior, anal cytology, HPV DNA, histology and HPV serology. HPV incidence during periods when zero sexual partners were reported in the last six months at both the current and previous annual visit ("no sexual activity") was analyzed by Cox regression using the Wei-Lin-Weissfeld method to determine univariable predictors. RESULTS Of 617 men enrolled, 525 had results for ≥2 visits, of whom 58 (11%) had ≥ one period of "no sexual activity". During sexually inactive periods, there were 29 incident high risk HPV infections in 20 men, which occurred more commonly in older men (Ptrend = 0.010), HIV-positive men (HR = 3.12; 95% CI, 0.91-16.65), longer duration of HIV (Ptrend = 0.028), history of AIDS defining illness (P = 0.010), lower current (P = 0.010) and nadir CD4 count (P = 0.014). For 18 of 29 infections with available results, 12 men remained type-specific HRHPV L1 seronegative. None were consistently seropositive. A new diagnosis of HSIL occurred in only two men, caused by an HPV type other than the incident type. CONCLUSIONS Our findings suggest that in sexually inactive GBM, anal HRHPV incidence is relatively common, and is associated with increasing age and immune dysfunction, a pattern consistent with HPV reactivation. IMPACT Reactivation of anal HPV may occur.
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Affiliation(s)
- I Mary Poynten
- The Kirby Institute, Wallace Wurth Building, University of New South Wales, Kensington, Sydney, New South Wales, Australia
| | - Fengyi Jin
- The Kirby Institute, Wallace Wurth Building, University of New South Wales, Kensington, Sydney, New South Wales, Australia
| | - Monica Molano
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Melbourne, Victoria, Australia.,Molecular Microbiology, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia
| | - Jennifer M Roberts
- Douglass Hanly Moir Pathology, Macquarie Park, Sydney, New South, Wales, Australia
| | - Richard J Hillman
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Melbourne, Victoria, Australia.,St Vincent's Hospital, Darlinghurst, Sydney, New South Wales, Australia
| | - David J Templeton
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Melbourne, Victoria, Australia.,Department of Sexual Health Medicine, Sydney Local Health District, Camperdown, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Carmella Law
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Melbourne, Victoria, Australia.,St Vincent's Hospital, Darlinghurst, Sydney, New South Wales, Australia
| | | | - Tim Waterboer
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Annabelle Farnsworth
- Douglass Hanly Moir Pathology, Macquarie Park, Sydney, New South, Wales, Australia
| | | | - Suzanne M Garland
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Melbourne, Victoria, Australia.,Molecular Microbiology, Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Melbourne, Victoria, Australia
| | - Andrew E Grulich
- The Kirby Institute, Wallace Wurth Building, University of New South Wales, Kensington, Sydney, New South Wales, Australia
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75
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Zhang L, Tan W, Yang H, Zhang S, Dai Y. Detection of Host Cell Gene/HPV DNA Methylation Markers: A Promising Triage Approach for Cervical Cancer. Front Oncol 2022; 12:831949. [PMID: 35402283 PMCID: PMC8990922 DOI: 10.3389/fonc.2022.831949] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/28/2022] [Indexed: 02/05/2023] Open
Abstract
Cervical cancer is the most prevalent gynecologic malignancy, especially in women of low- and middle-income countries (LMICs). With a better understanding of the etiology and pathogenesis of cervical cancer, it has been well accepted that this type of cancer can be prevented and treated via early screening. Due to its higher sensitivity than cytology to identify precursor lesions of cervical cancer, detection of high-risk human papillomavirus (HR-HPV) DNA has been implemented as the primary screening approach. However, a high referral rate for colposcopy after HR-HPV DNA detection due to its low specificity in HR-HPV screening often leads to overtreatment and thus increases the healthcare burden. Emerging evidence has demonstrated that detection of host cell gene and/or HPV DNA methylation represents a promising approach for the early triage of cervical cancer in HR-HPV-positive women owing to its convenience and comparable performance to cytology, particularly in LMICs with limited healthcare resources. While numerous potential markers involving DNA methylation of host cell genes and the HPV genome have been identified thus far, it is crucial to define which genes or panels involving host and/or HPV are feasible and appropriate for large-scale screening and triage. An ideal approach for screening and triage of CIN/ICC requires high sensitivity and adequate specificity and is suitable for self-sampling and inexpensive to allow population-based screening, particularly in LMICs. In this review, we summarize the markers of host cell gene/HR-HPV DNA methylation and discuss their triage performance and feasibility for high-grade precancerous cervical intraepithelial neoplasia or worse (CIN2+ and CIN3+) in HR-HPV-positive women.
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Affiliation(s)
- Lingyi Zhang
- Laboratory of Cancer Precision Medicine, The First Hospital of Jilin University, Changchun, China.,Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, China
| | - Wenxi Tan
- Department of Gynecology and Obstetrics, The Second Hospital of Jilin University, Changchun, China
| | - Hongmei Yang
- Laboratory of Cancer Precision Medicine, The First Hospital of Jilin University, Changchun, China.,Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China
| | - Songling Zhang
- Department of Obstetrics and Gynecology, The First Hospital of Jilin University, Changchun, China
| | - Yun Dai
- Laboratory of Cancer Precision Medicine, The First Hospital of Jilin University, Changchun, China
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Prasad SK, Bhat S, Shashank D, C R A, R S, Rachtanapun P, Devegowda D, Santhekadur PK, Sommano SR. Bacteria-Mediated Oncogenesis and the Underlying Molecular Intricacies: What We Know So Far. Front Oncol 2022; 12:836004. [PMID: 35480118 PMCID: PMC9036991 DOI: 10.3389/fonc.2022.836004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/22/2022] [Indexed: 01/10/2023] Open
Abstract
Cancers are known to have multifactorial etiology. Certain bacteria and viruses are proven carcinogens. Lately, there has been in-depth research investigating carcinogenic capabilities of some bacteria. Reports indicate that chronic inflammation and harmful bacterial metabolites to be strong promoters of neoplasticity. Helicobacter pylori-induced gastric adenocarcinoma is the best illustration of the chronic inflammation paradigm of oncogenesis. Chronic inflammation, which produces excessive reactive oxygen species (ROS) is hypothesized to cause cancerous cell proliferation. Other possible bacteria-dependent mechanisms and virulence factors have also been suspected of playing a vital role in the bacteria-induced-cancer(s). Numerous attempts have been made to explore and establish the possible relationship between the two. With the growing concerns on anti-microbial resistance and over-dependence of mankind on antibiotics to treat bacterial infections, it must be deemed critical to understand and identify carcinogenic bacteria, to establish their role in causing cancer.
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Affiliation(s)
- Shashanka K Prasad
- Department of Biotechnology and Bioinformatics, Faculty of Life Sciences, Jagadguru Sri Shivarathreeshwara (JSS) Academy of Higher Education and Research (JSSAHER), Mysuru, India
| | - Smitha Bhat
- Department of Biotechnology and Bioinformatics, Faculty of Life Sciences, Jagadguru Sri Shivarathreeshwara (JSS) Academy of Higher Education and Research (JSSAHER), Mysuru, India
| | - Dharini Shashank
- Department of General Surgery, Adichunchanagiri Institute of Medical Sciences, Mandya, India
| | - Akshatha C R
- Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Sindhu R
- Department of Microbiology, Faculty of Life Sciences, Jagadguru Sri Shivarathreeshwara (JSS) Academy of Higher Education and Research (JSSAHER), Mysuru, India
| | - Pornchai Rachtanapun
- School of Agro-Industry, Faculty of Agro-Industry, Chiang Mai University, Chiang Mai, Thailand
- Cluster of Agro Bio-Circular-Green Industry (Agro BCG), Chiang Mai University, Chiang Mai, Thailand
| | - Devananda Devegowda
- Centre of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, India
| | - Prasanna K Santhekadur
- Centre of Excellence in Molecular Biology and Regenerative Medicine (CEMR), Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research (JSSAHER), Mysuru, India
| | - Sarana Rose Sommano
- Cluster of Agro Bio-Circular-Green Industry (Agro BCG), Chiang Mai University, Chiang Mai, Thailand
- Department of Plant and Soil Sciences, Faculty of Agriculture, Chiang Mai University, Chiang Mai, Thailand
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Eche MT, Vermaak K. Knowledge, attitude and practice of female university students regarding human papillomavirus and self-sampling in KwaZulu-Natal, South Africa: a cross-sectional survey. BMC Womens Health 2022; 22:58. [PMID: 35246111 PMCID: PMC8895517 DOI: 10.1186/s12905-022-01634-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection remains a major cause of cervical cancer. Screening practice in South Africa has remained persistently low, with the invasiveness of pelvic examination as a major barrier to screening. This occasions the need to assess women's knowledge, attitude, and practice regarding HPV testing and self-sampling. METHOD This is a cross-sectional quantitative study which enrolled 386 female students between the ages of 18 and 65 years at the University of KwaZulu-Natal, South Africa. Data was collected through a self-administered structured questionnaire, from February to March 2020. Data on participants' socio-demographic characteristics, knowledge, attitudes and practices regarding HPV, HPV testing and self-sampling were obtained. RESULTS Out of the 386 respondents, 30.6% were unaware that HPV can be transmitted through unprotected sex, only 25.1% knew about the availability of HPV vaccines in South Africa, 16.1% knew that the vaccines are accessible for free, while 79.0% were oblivious to the asymptomatic nature of HPV infection. Furthermore, a vast majority (95.8%) had never heard about self-sampling while only 1.0% had undergone HPV testing prior to this study. Although 52.9% knew that HPV testing could prevent cervical cancer, it did not positively impact screening practice. However, 57.7% of participants were willing to undergo future screening if allowed to self-sample. CONCLUSION Self-sampling is a more acceptable means of sample collection compared to pelvic examination. Therefore, encouraging self-sampling and providing self-sampling kits will aid increased screening participation and address certain barriers associated with HPV testing. Awareness and educational campaigns about HPV and its causative relationship with cervical cancer will occasion better attitude towards screening participation.
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Affiliation(s)
- Miracle Tamaraebi Eche
- School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa.
| | - Kerry Vermaak
- School of Built Environment and Development Studies, University of KwaZulu-Natal, Durban, South Africa
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Mirandez CC, Yoneda JY, Gertrudes LN, Carvalho CF, Derchain S, Teixeira JC, Vale DB. The value of the endocervical margin status in LEEP: analysis of 610 cases. Arch Gynecol Obstet 2022; 306:851-856. [DOI: 10.1007/s00404-022-06464-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/14/2022] [Indexed: 12/24/2022]
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Fu Y, Li X, Li Y, Lu W, Xie X, Wang X. Head-to-Head Comparison of DH3 HPV Test and HC2 Assay for Detection of High-Risk HPV Infection in Residual Cytology Samples from Cervical Cancer Screening Setting: Baseline and 3-Year Longitudinal Data. Microbiol Spectr 2022; 10:e0157021. [PMID: 35171029 PMCID: PMC8849094 DOI: 10.1128/spectrum.01570-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/14/2022] [Indexed: 11/20/2022] Open
Abstract
The authors compared the clinical performance of DH3 human papillomavirus (HPV) assay, which detects 14 high-risk HPVs with 16/18 genotyping based on hybrid capture technique, and Hybrid Capture 2 (HC2) test for women undergoing cervical cancer screening. A total of 7, 263 residual cytology specimens from an adjudicated cohort with 3-year follow-up were tested by the DH3 assay and the HC2 test. Assay results were compared with each other and to histology review. The overall agreement between the DH3 assay and the HC2 test was 99.2% (κ = 0.938). At baseline, DH3 had the equal sensitivity to that of HC2 for cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN2+, n = 75) and CIN grade 3 or higher (CIN3+, n = 45), 98.67% and 97.78%, respectively. After 3 years of follow-up, the sensitivity for CIN2+ (n = 133) and CIN3+ (n = 74) were both similar between DH3 and HC2 (95.49% vs 94.74%, 95.95% vs 95.95%, respectively, all P > 0.05). The respective specificity for CIN2+ or CIN3+ did not differ between the two tests. A noninferiority test showed that both sensitivity and specificity of DH3 for CIN2+ and CIN3+ were noninferior to those of HC2 at baseline and after 3-year follow-up, respectively (all P < 0.001). When used in primary screening strategy, the DH3 assay would yield an immediate sensitivity of 92% for CIN2+. DH3 HPV performs equally to HC2 for the detection of high-grade lesions in cervical cancer screening and has a potential advantage in primary screening strategy due to HPV16/18 genotyping. IMPORTANCE The benefits of testing for high-risk human papillomavirus (hrHPV) in cervical cancer screening have already been demonstrated. Hybrid Capture 2 (HC2) is the best validated HPV assay and has been considered the gold standard for hrHPV testing. However, HC2 cannot discriminate HPV16 and 18 from the other hrHPV types, which greatly limited the application of HC2 in cervical cancer screening. The DH3 human papillomavirus (HPV) is a recently developed assay based on hybrid capture technique like to HC2, which can specifically identify HPV 16/18 on the basis of detecting the 13 hrHPV types targeted by HC2 as well as HPV66. This comparative study of the two assays for detection of hrHPV infection in residual cytology samples from cervical cancer screening setting reveals that DH3 HPV provides a perfect alternative to HC2 in detecting hrHPV infection and identifying cervical precancer, while allowing concurrent HPV 16/18 genotyping.
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Affiliation(s)
- Yunfeng Fu
- Centre for Diagnosis & Treatment of Cervical Diseases, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiao Li
- Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Li
- Centre for Diagnosis & Treatment of Cervical Diseases, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Weiguo Lu
- Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xing Xie
- Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinyu Wang
- Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Machalek D, Rees H, Chikandiwa A, Munthali R, Travill D, Mbulawa Z, Petoumenos K, Delany-Moretlwe S, Kaldor J. Impact of one and two human papillomavirus (HPV) vaccine doses on community-level HPV prevalence in South African adolescent girls: study protocol and rationale for a pragmatic before-after design. BMJ Open 2022; 12:e059968. [PMID: 35144959 PMCID: PMC8845310 DOI: 10.1136/bmjopen-2021-059968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/20/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Vaccines against human papillomavirus (HPV) are the key to controlling cervical cancer in low/middle-income countries (LMICs) where incidence is highest, but there have been limited data from these settings on programme impact on HPV prevalence, and none in a population with endemic HIV infection. Furthermore, for many LMICs, the currently recommended two-dose schedule is difficult to deliver at scale, so there is mounting interest in a single-dose schedule. METHODS AND ANALYSIS The Human Papillomavirus One and Two-Dose Population Effectiveness Study is a hybrid impact evaluation of the national South African HPV vaccination programme, which has targeted grade 4 girls aged at least 9 years in public schools with two doses of vaccine since 2014, and a single-dose vaccine 'catch-up' programme delivered in one district in 2019. Impacts of both schedules on the prevalence of type-specific HPV infection will be measured using repeat cross-sectional surveys in adolescent girls and young women aged 17-18 years recruited at primary healthcare clinics in the four provinces. A baseline survey in 2019 measured HPV prevalence in the cohort who were ineligible for vaccination because they were already above the target age or grade under either the national programme or the single-dose programme in the selected district. HPV prevalence surveys are repeated in 2021 in the selected district, and in 2023 in all four provinces. We will calculate prevalence ratios to compare the prevalence of HPV types 16 and 18 in the single-dose (2021) and two-dose (2023) cohorts, with the vaccine-ineligible (2019) cohort. ETHICS AND DISSEMINATION The project was approved by the University of the Witwatersrand Human Research Ethics Committee (HREC #181005), and the University of New South Wales HREC (#181-005). Findings will be disseminated through peer-reviewed journals, scientific meetings, reports and community forums.
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Affiliation(s)
- Dorothy Machalek
- Kirby Institute, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Helen Rees
- Wits RHI, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Admire Chikandiwa
- Wits RHI, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Richard Munthali
- Wits RHI, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Danielle Travill
- Wits RHI, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Zizipho Mbulawa
- UCT-MRC Clinical Gynaecological Cancer Research Centre, University of Cape Town, Rondebosch, Western Cape, South Africa
- Department of Laboratory Medicine and Pathology, Walter Sisulu University, Mthatha, Eastern Cape, South Africa
| | - Kathy Petoumenos
- Kirby Institute, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
| | | | - John Kaldor
- Kirby Institute, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
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Asaturova A, Dobrovolskaya D, Magnaeva A, Tregubova A, Bayramova G, Sukhikh G. Cervical Cytology–Histology Correlation Based on the American Society of Cytopathology Guideline (2017) at the Russian National Medical Research Center for Obstetrics, Gynecology, and Perinatology. Diagnostics (Basel) 2022; 12:diagnostics12010210. [PMID: 35054376 PMCID: PMC8775185 DOI: 10.3390/diagnostics12010210] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/09/2022] [Accepted: 01/13/2022] [Indexed: 12/10/2022] Open
Abstract
Recent evidence suggests that a cytology–histology correlation (CHC) with discrepancy detection can both evaluate errors and improve the sensitivity and specificity of the cytologic method. We aimed to analyze the errors in cytologic–histologic discrepancies according to the CHC protocol guideline of the American Society of Cytopathology (2017). This retrospective study included 273 patients seen at the National Medical Research Center of Obstetrics, Gynecology and Perinatology (Moscow, Russia) between January 2019 and September 2021. The patients’ mean age was 34 ± 8.1 years. The cytology–histology agreement was noted in 158 cases (57.9%). Major discrepancies were found in 21 cases (7.6%), while minor discrepancies were noted in 93 cases (34.1%). The reason for 13 (4.8%) discrepancies was a colposcopy sampling error and, in 46 (16.8%) cases, the reason was a Papanicolaou (PAP) test sampling error. The discrepancy between primary and reviewed cytology was due interpretive errors in 13 (4.8%) cases and screening errors in 42 (15.4%) cases. We demonstrated that the ASC guidelines facilitate cervical CHC. A uniform application of these guidelines would standardize cervical CHCs internationally, provide a scope for the inter-laboratory comparison of data, and enhance self-learning and peer learning.
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Johnson LG, Saidu R, Svanholm-Barrie C, Boa R, Moodley J, Tergas A, Persing D, Campbell SA, Tsai WY, Wright TC, Denny L, Kuhn L. Clinical utility of reflex testing with cancer biomarkers to improve diagnostic accuracy of primary Human Papillomavirus screening. Cancer Epidemiol Biomarkers Prev 2022; 31:595-603. [PMID: 35027434 DOI: 10.1158/1055-9965.epi-21-0972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 11/02/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND HPV testing is the cornerstone of cervical cancer screening with outstanding sensitivity but only moderate specificity. We evaluated whether reflex testing for cancer biomarkers improves the sensitivity/specificity balance of screening. METHODS Cervical samples from women in Cape Town, South Africa, aged 30-65 years, were collected and tested with Xpert HPV and with real-time PCR to detect mRNA for Cyclin-Dependent Kinase Inhibitor 2A (CDKN2A), Topoisomerase 2 alpha (TOP2A) and Ki67 (MKi67). Women with histologically-confirmed cervical intraepithelial neoplasia grade 2 or worse (CIN2+) (85 women without and 166 with HIV) and women with no cervical disease (331 without and 257 with HIV) were included. RESULTS When used as reflex tests after a positive HPV result, biomarkers discriminated well between women with and without CIN2+. The inclusion of both CDKN2A and MKi67 had the best performance with area under the curve (AUC) of 0.9171 and 0.8734 in women without and with HIV, respectively. While excellent, these performance parameters did not improve on an approach utilizing only HPV testing with more stringent cycle threshold cut-offs and HPV genotype selection which achieved AUC of 0.9059 and 0.8705 in women without and with HIV, respectively. CONCLUSION Biomarkers can be used as triage after positive HPV results but do not out-perform an approach utilizing higher viral load cut-offs on selected high-risk genotypes. IMPACT A screening approach using HPV testing alone can be more easily implemented at the point-of-care.
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Affiliation(s)
| | - Rakiya Saidu
- Department of Obstetrics and Gynecology; South African Medical Research Council Gynaecological Cancer Research Centre (SAMRC GCRC), University of Cape Town
| | | | - Rosalind Boa
- Department of Obstetrics and Gynecology, University of Cape Town
| | - Jennifer Moodley
- School of Public Health and Family Medicine; South African Medical Research Council Gynaecological Cancer Research Centre (SAMRC GCRC), University of Cape Town
| | | | | | | | | | | | - Lynette Denny
- Department of Obstetrics and Gynecology, University of Cape Town
| | - Louise Kuhn
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center; Department of Epidemiology, Mailman School of Public Health, Columbia University, Columbia University Irving Medical Center
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Terasawa T, Hosono S, Sasaki S, Hoshi K, Hamashima Y, Katayama T, Hamashima C. Comparative accuracy of cervical cancer screening strategies in healthy asymptomatic women: a systematic review and network meta-analysis. Sci Rep 2022; 12:94. [PMID: 34997127 PMCID: PMC8741996 DOI: 10.1038/s41598-021-04201-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/17/2021] [Indexed: 02/01/2023] Open
Abstract
To compare all available accuracy data on screening strategies for identifying cervical intraepithelial neoplasia grade ≥ 2 in healthy asymptomatic women, we performed a systematic review and network meta-analysis. MEDLINE and EMBASE were searched up to October 2020 for paired-design studies of cytology and testing for high-risk genotypes of human papillomavirus (hrHPV). The methods used included a duplicate assessment of eligibility, double extraction of quantitative data, validity assessment, random-effects network meta-analysis of test accuracy, and GRADE rating. Twenty-seven prospective studies (185,269 subjects) were included. The combination of cytology (atypical squamous cells of undetermined significance or higher grades) and hrHPV testing (excepting genotyping for HPV 16 or 18 [HPV16/18]) with the either-positive criterion (OR rule) was the most sensitive/least specific, whereas the same combination with the both-positive criterion (AND rule) was the most specific/least sensitive. Compared with standalone cytology, non-HPV16/18 hrHPV assays were more sensitive/less specific. Two algorithms proposed for primary cytological testing or primary hrHPV testing were ranked in the middle as more sensitive/less specific than standalone cytology and the AND rule combinations but more specific/less sensitive than standalone hrHPV testing and the OR rule combination. Further research is needed to assess these results in population-relevant outcomes at the program level.
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Affiliation(s)
- Teruhiko Terasawa
- Section of General Internal Medicine, Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoake, Aichi, 470-1192, Japan.
| | - Satoyo Hosono
- Division of Cancer Screening Assessment and Management, Center for Public Health Science, National Cancer Center, Tokyo, Japan
| | - Seiju Sasaki
- Center for Preventive Medicine, St. Luke's International Hospital Affiliated Clinic, Tokyo, Japan
| | - Keika Hoshi
- Center for Public Health Informatics, National Institute of Public Health, Wako, Japan
| | - Yuri Hamashima
- Department of Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Takafumi Katayama
- Department of Statistics and Computer Science, College of Nursing Art and Science, University of Hyogo, Hyogo, Japan
| | - Chisato Hamashima
- Department of Nursing, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
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Song F, Yan P, Huang X, Wang C, Du H, Qu X, Wu R. Roles of extended human papillomavirus genotyping and multiple infections in early detection of cervical precancer and cancer and HPV vaccination. BMC Cancer 2022; 22:42. [PMID: 34991494 PMCID: PMC8734293 DOI: 10.1186/s12885-021-09126-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background The aim of the study was to investigate the risk of human papillomavirus (HPV) genotyping particularly vaccine genotypes and multiple infections for cervical precancer and cancer, which might contribute to developing genotype-specific screening strategy and assessing potential effects of HPV vaccine. Methods The HPV genotypes were identified using the Seq HPV assay on self-collected samples. Hierarchical ranking of each genotype was performed according to positive predictive value (PPV) for cervical intraepithelial neoplasia 2/3 or worse (CIN2+/CIN3+). Multivariate logistic regression model was used to estimate the odds ratios (ORs) with 95% confidence interval (CI) of CIN2+ according to multiplicity of types and vaccine types. Results A total of 2811 HPV-positive women were analyzed. The five dominant HPV genotypes in high-grade lesions were 16/58/52/33/18. The overall ranking orders were HPV16/33/35/58/31/68/18/ 56/52/66/51/59/45/39 for CIN2+ and HPV16/33/31/58/45/66/52/18/35/56/51/68/59/39 for CIN3+. The risks of single infection versus co-infections with other types lower in the hierarchy having CIN2+ were not statistically significant for HPV16 (multiple infection vs. single infection: OR = 0.8, 95%CI = 0.6-1.1, P = 0.144) or other genotypes (P > 0.0036) after conservative Bonferroni correction. Whether HPV16 was present or not, the risks of single infection versus multiple infection with any number (2, ≥2, or ≥ 3) of types for CIN2+ were not significantly different. In addition, HPV31/33/45/52/58 covered by nonavalent vaccine added 27.5% of CIN2, 23.0% of CIN3, and 12.5% of cancer to the HPV16/18 genotyping. These genotype-groups were at significantly higher risks than genotypes not covered by nonavalent vaccine. Moreover, genotypes covered by nonavalent vaccine contributed to 85.2% of CIN2 lesions, 97.9% of CIN3 and 93.8% of cancers. Conclusions Partial extended genotyping such as HPV33/31/58 but not multiplicity of HPV infections could serve as a promising triage for HPV-positive self-samples. Moreover, incidence rates of cervical cancer and precancer were substantial attributable to HPV genotypes covered by current nonavalent vaccination. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-09126-3.
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Affiliation(s)
- Fangbin Song
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China
| | - Peisha Yan
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China
| | - Xia Huang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China
| | - Chun Wang
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China.,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China.,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China
| | - Hui Du
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China. .,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China. .,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China.
| | - Xinfeng Qu
- Sanming Project of Medicine in Shenzhen, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, China.
| | - Ruifang Wu
- Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518036, Guangdong, P. R. China. .,Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, 518036, Guangdong, P. R. China. .,Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, 518036, Guangdong, P. R. China.
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Brunner A, Kruis W, Schömig-Markiefka B, Morgenstern J, Engels M, Büttner R, Forner DM. Prevalence of abnormal Pap smear results in inflammatory bowel disease: a prospective study. J Cancer Res Clin Oncol 2022; 148:3071-3079. [PMID: 34981194 DOI: 10.1007/s00432-021-03909-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/27/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Development of malignancy is a pending threat for patients with inflammatory bowel disease (IBD). Aim of this study was to analyze cervical dysplasia and infection with human papilloma virus (HPV) in patients with IBD. METHODS This was a prospective, single center cohort study in Germany. Consecutive IBD patients admitted to the Department of Gastroenterology were sent to Gynecology, where a questionnaire was answered and gynecological examinations including a smear for cytology and HPV were taken. Participants of a general screening program constituted controls. Descriptive statistics, 95% confidence intervals and odds ratios were calculated. RESULTS A total of 101 patients were recruited of which 99 patients participated. Analysis showed a significant (p = 0.05) difference between the prevalence of abnormal smears in patients with (22%) and without (6%) immunosuppressive therapy, while the latter had cervical abnormalities comparable with healthy controls (5%). All immunosuppressants showed similarly high risks for abnormal smear results. Only 11/99 (11%) patients had positive high-risk HPV tests, which is comparable with general population. CONCLUSION The prevalence of abnormal cervical smears is higher in IBD patients compared to healthy individuals, but the difference is confined to patients with IBD and immunosuppressive therapy. Annual screening is advisable.
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Affiliation(s)
- Andrea Brunner
- Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103, Köln, Germany
| | - Wolfgang Kruis
- Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103, Köln, Germany.
| | | | - Julia Morgenstern
- Abteilung für Gastroenterologie, Pulmologie und Allgemeine Innere Medizin, Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103, Köln, Germany
| | - Marianne Engels
- Institut für Pathologie des Universitätsklinikums Köln, Kerpener Str. 62, 50937, Köln, Germany
| | - Reinhard Büttner
- Institut für Pathologie des Universitätsklinikums Köln, Kerpener Str. 62, 50937, Köln, Germany
| | - Dirk Michael Forner
- Klinik für Gynäkologie und Geburtshilfe, Evangelisches Krankenhaus Kalk, Buchforststr. 2, 51103, Köln, Germany
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Lorenzi NPC, Termini L, Ferreira-Filho ES, Nunes RAL, Silva GAF, Lepique AP, Longatto-Filho A, Tacla M, Baracat EC, Villa LL, Soares-Júnior JM. A positive HPV test with positive p16/Ki-67 double staining in self-sampled vaginal material is an accurate tool to detect women at risk for cervical cancer. Cancer Cytopathol 2022; 130:41-54. [PMID: 34375039 DOI: 10.1002/cncy.22498] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND The development of efficient strategies for managing high-risk human papillomavirus (HR-HPV)-positive women is a major challenge when human papillomavirus-based primary screening is being performed. The objectives of this study were to evaluate the comparative effectiveness of HR-HPV testing based on self-collection (SC) and HR-HPV testing based on collection by a health professional (HP) and to assess the potential usefulness of HR-HPV testing combined with testing with the biomarkers p16/Ki-67, α-mannosidase, and superoxide dismutase 2 (SOD2). METHODS This was a cross-sectional study of 232 women admitted for colposcopy because of an abnormal Papanicolaou smear. The collected material underwent liquid-based cytology, HR-HPV detection, and immunocytochemical testing (p16/Ki-67, α-mannosidase, and SOD2). The gold standard was the histopathological result; the positive reference was CIN2+. RESULTS The overall accuracy of HR-HPV testing was 76.6%; the results for the SC group (78.1%) and the HP group (75.2%) were similar. The positive predictive values (HP, 76.5%; SC, 80.0%), the negative predictive values (HP, 66.7%; SC, 64.3%), the positive likelihood values (HP, 1.35; SC, 1.36), and the negative likelihood values (HP, 0.21; SC, 0.19) were also similar. p16/Ki-67 showed higher sensitivity than the other 2 biomarkers: 78.1% versus 45.8% for α-mannosidase and 44.5% for SOD2. The specificities of the biomarkers were equivalent: 71.4% for p16/Ki-67, 77.8% for α-mannosidase, and 71.2% for SOD2. In the HP group, accuracy also leaned more heavily toward the final score (using α-mannosidase and SOD2) without statistical significance (80.8% vs 77.9%). The contrast with the SC group yielded the same level of accuracy. CONCLUSIONS SC, when associated with testing with biomarkers, is as accurate as collection by HPs in the detection of women at risk for cervical cancer.
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Affiliation(s)
- Noely P C Lorenzi
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Ginecologia, Hospital Universitario, Universidade de São Paulo, São Paulo, Brazil
| | - Lara Termini
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Edson S Ferreira-Filho
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Divisao de Clínica Ginecologica, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Rafaella A L Nunes
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Gabriela A F Silva
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ana P Lepique
- Instituto de Ciencias Biomedicas, Universidade de São Paulo, São Paulo, Brazil
| | - Adhemar Longatto-Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital/Pio XII Foundation, São Paulo, Brazil
- Medical Laboratory of Medical Investigation 14, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Department of Pathology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Research Institute of Life and Health Sciences, University of Minho, Braga, Portugal
- 8ICVS/3B's-Associated Laboratory to the Government of Portugal, Braga/Guimaraes, Portugal
| | - Maricy Tacla
- Divisao de Clínica Ginecologica, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Edmund C Baracat
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Divisao de Clínica Ginecologica, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luisa L Villa
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Department of Radiology and Oncology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - José M Soares-Júnior
- Disciplina de Ginecologia, Departamento de Obstetricia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Divisao de Clínica Ginecologica, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Prelić J, Knežević A. The frequency of infection with high-risk human papilloma virus types on the cervix uteri of women of reproductive age. MEDICINSKI PODMLADAK 2022. [DOI: 10.5937/mp73-33477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Human papilloma virus is the most important etiological factor that leads to the malignant alteration of cervical epithelium. More than 200 types of human papillomavirus are identified. Based on its oncogenic potential, human papillomavirus can be classified as low-oncogenic and high-oncogenic types. Aim: To determine the frequency of infection with high-risk human papillomaviruses in the cervical swabs of reproductively active women in our population. Material and methods: The research is designed as descriptive study. Data on the presence of HPV infections, as well as the virus genotype in 707 cervical swabs from the period from January 2019 to August 2020, together with the correlation with the woman's age and cytological status on the cervix, were analyzed. Results: Human papilloma virus infection was present in 223 out of 707 tested samples (31.54%). The highest frequency of HPV infection, as well as the highest number of HPV genotypes was in the group of women aged 25 - 34 years (36.32%). The frequency of HPV infection correlates with altered cytological status. The presence of 26 HPV genotypes was determined, 16 highly oncogenic and 10 low oncogenic types, of which the most common was highly oncogenic type 16 (25.11%). Conclusion: These findings showed a high frequency of highly oncogenic HPV genotypes, primarily type 16 in most groups of women of reproductive age. In addition, the frequency of infection correlates with cytological status, which indicates the great importance of prevention of genital HPV infection in our female population.
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Effects of Traditional Chinese Medicine for Vaginal Lavage Combined with Psychological Intervention in Postoperative Patients with Cervical Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5751795. [PMID: 34956380 PMCID: PMC8694975 DOI: 10.1155/2021/5751795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/15/2021] [Indexed: 01/19/2023]
Abstract
Purpose To explore the effects of traditional Chinese medicine for vaginal lavage combined with psychological intervention on the immune function and clinical efficacy in patients with cervical cancer. Methods Patients with cervical cancer treated in our hospital from January 2020 to May 2021 were included in this study. All patients were treated with traditional Chinese medicine for vaginal lavage combined with psychological nursing intervention. The treatment outcomes of the patients were observed, and the quality-of-life scores and depression of the patients before and after treatment were compared. Changes in T-lymphocyte subset-related indicators, changes in blood routine-related indicators, and changes in the detection level of tumor markers were compared with anxiety scores. Results After treatment, depression and anxiety were significantly reduced and the patient's quality of life significantly improved. After treatment, the patient's CD3+, CD4+, and CD4+/CD8+ proportions were dramatically higher than before treatment (P < 0.05), there was no significant difference in CD8+ proportion before and after treatment (P > 0.05), and the white blood cell (WBC), hemoglobin (Hb), platelet (PLT) of patients, and the level of tumor marker (CA125) after treatment were immensely lower than before treatment (P < 0.05). Conclusions Treating patients with cervical cancer with traditional Chinese medicine for vaginal lavage combined with psychological nursing can effectively improve the patient's immune function, effectively reduce the level of tumor marker CA125, increase the level of T-lymphocyte subsets, and improve the bone marrow hematopoietic function.
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Lu Y, Chen Y, Zhang Z, Li M, Chen X, Tu K, Li L. HPV16 E6 promotes cell proliferation, migration, and invasion of human cervical cancer cells by elevating both EMT and stemness characteristics. Cell Biol Int 2021; 46:599-610. [PMID: 34957655 DOI: 10.1002/cbin.11756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 12/06/2021] [Accepted: 12/22/2021] [Indexed: 12/24/2022]
Abstract
In most cases of cervical cancer, the high-risk of the disease is caused by the human papilloma virus (HPV). Surgery or radiation usually benefits patients with early cervical cancer, while the metastatic one is uncurable and new therapeutic strategies and approaches are required. In this study, HPV16 E6 silence or overexpression were carried out to evaluate the possible mechanisms of HPV16 E6 function in cervical cancer cells with different HPV16 E6 expression background. HPV16 E6-positive cervical cancer cell Siha exerts significantly stronger cell invasion and migration potentials than the HPV16 E6-negative C33A cells. HPV16 E6 silence significantly weakened the potentials of cell invasion and migration, cell proliferation and stemness characteristic in Siha cells. Meanwhile, the overexpression of HPV16 E6 effectively promoted the cell proliferation and stemness characteristic in C33A cells. Our data also indicated a positive association between HPV16 E6 and the levels of epithelial to mesenchymal transition (EMT), and cell stemness. The ectopic expression of OCT4 could effectively reverse the inhibitory roles of HPV16 E6 silence on cell migration, invasion, and stemness in Siha cells. More interestingly, we found that HPV16 E6 might promote the OCT4 expression by impairing the direct binding of p53 on the promoter and activate its transcription. Taken together, our results indicated that HPV16 E6 could promoted the potential cell proliferation, migration, and invasion of human cervical cancer cells by modulating EMT and cell stemness. Our data provide a novel mechanism for how HPV16 E6 acts as a key risk factor for cervical cancer development and progression. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- YuFen Lu
- Medical College of NanChang University, Nanchang, Jiangxi, P R China
| | - Yu Chen
- The Second Affiliated Hospital of NanChang University, Nanchang, Jiangxi, P R China
| | - ZiYu Zhang
- Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, P R China
| | - MingMei Li
- Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, P R China
| | - XiaoXiao Chen
- Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, P R China
| | - KaiJia Tu
- Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, P R China
| | - LongYu Li
- Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, P R China
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Mahmood HTNA, Tomas Bort E, Walker AJ, Grose RP, Chioni AM. FGF signalling facilitates cervical cancer progression. FEBS J 2021; 289:3440-3456. [PMID: 34951738 DOI: 10.1111/febs.16331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/26/2021] [Accepted: 12/21/2021] [Indexed: 12/18/2022]
Abstract
Cervical cancer is one of the most frequently diagnosed cancers in women worldwide. While cervical cancer is caused by human papillomavirus (HPV), not all females infected with HPV develop the disease, suggesting that other factors might facilitate its progression. Growing evidence supports the involvement of the fibroblast growth factor receptor (FGFR) axis in several cancers, including gynecological. However, for cervical cancer, the molecular mechanisms that underpin the disease remain poorly understood, including the role of FGFR signaling. The aim of this study was to investigate FGF(R) signaling in cervical cancer through bioinformatic analysis of cell line and patient data and through detailed expression profiling, manipulation of the FGFR axis, and downstream phenotypic analysis in cell lines (HeLa, SiHa, and CaSki). Expression (protein and mRNA) analysis demonstrated that FGFR1b/c, FGFR2b/c, FGFR4, FGF2, FGF4, and FGF7 were expressed in all three lines. Interestingly, FGFR1 and 2 localized to the nucleus, supporting that nuclear FGFRs could act as transcription factors. Importantly, 2D and 3D cell cultures demonstrated that FGFR activation can facilitate cell functions correlated with invasive disease. Collectively, this study supports an association between FGFR signaling and cervical cancer progression, laying the foundations for the development of therapeutic approaches targeting FGFR in this disease.
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Affiliation(s)
| | - Elena Tomas Bort
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, UK
| | - Anthony J Walker
- School of Life Sciences Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
| | - Richard P Grose
- Centre for Tumour Biology, Barts Cancer Institute, Queen Mary University of London, UK
| | - Athina-Myrto Chioni
- School of Life Sciences Pharmacy and Chemistry, Kingston University, Kingston upon Thames, UK
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91
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The Role of Chemokines in Cervical Cancers. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57111141. [PMID: 34833360 PMCID: PMC8619382 DOI: 10.3390/medicina57111141] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 12/12/2022]
Abstract
Both clinical-pathological and experimental studies have shown that chemokines play a key role in activating the immune checkpoint modulator in cervical cancer progression and are associated with prognosis in tumor cell proliferation, invasion, angiogenesis, chemoresistance, and immunosuppression. Therefore, a clear understanding of chemokines and immune checkpoint modulators is essential for the treatment of this disease. This review discusses the origins and categories of chemokines and the mechanisms that are responsible for activating immune checkpoints in cervical dysplasia and cancer, chemokines as biomarkers, and therapy development that targets immune checkpoints in cervical cancer research.
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92
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Pinheiro M, Harari A, Schiffman M, Clifford GM, Chen Z, Yeager M, Cullen M, Boland JF, Raine-Bennett T, Steinberg M, Bass S, Xiao Y, Tenet V, Yu K, Zhu B, Burdett L, Turan S, Lorey T, Castle PE, Wentzensen N, Burk RD, Mirabello L. Phylogenomic Analysis of Human Papillomavirus Type 31 and Cervical Carcinogenesis: A Study of 2093 Viral Genomes. Viruses 2021; 13:1948. [PMID: 34696378 PMCID: PMC8540939 DOI: 10.3390/v13101948] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/09/2021] [Accepted: 09/21/2021] [Indexed: 12/17/2022] Open
Abstract
Human papillomavirus (HPV) type 31 (HPV31) is closely related to the most carcinogenic type, HPV16, but only accounts for 4% of cervical cancer cases worldwide. Viral genetic and epigenetic variations have been associated with carcinogenesis for other high-risk HPV types, but little is known about HPV31. We sequenced 2093 HPV31 viral whole genomes from two large studies, one from the U.S. and one international. In addition, we investigated CpG methylation in a subset of 175 samples. We evaluated the association of HPV31 lineages/sublineages, single nucleotide polymorphisms (SNPs) and viral methylation with cervical carcinogenesis. HPV31 A/B clade was >1.8-fold more associated with cervical intraepithelial neoplasia grade 3 and cancer (CIN3+) compared to the most common C lineage. Lineage/sublineage distribution varied by race/ethnicity and geographic region. A viral genome-wide association analysis identified SNPs within the A/B clade associated with CIN3+, including H23Y (C626T) (odds ratio = 1.60, confidence intervals = 1.17-2.19) located in the pRb CR2 binding-site within the E7 oncogene. Viral CpG methylation was higher in lineage B, compared to the other lineages, and was most elevated in CIN3+. In conclusion, these data support the increased oncogenicity of the A/B lineages and suggest variation of E7 as a contributing risk factor.
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Affiliation(s)
- Maisa Pinheiro
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
| | - Ariana Harari
- Departments of Pediatrics and Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
| | - Mark Schiffman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
| | - Gary M. Clifford
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), 150 cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (G.M.C.); (V.T.)
| | - Zigui Chen
- Department of Microbiology, The Chinese University of Hong Kong, Hong Kong, China;
| | - Meredith Yeager
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, MD 21701, USA
| | - Michael Cullen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, MD 21701, USA
| | - Joseph F. Boland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, MD 21701, USA
| | - Tina Raine-Bennett
- Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA;
| | - Mia Steinberg
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, MD 21701, USA
| | - Sara Bass
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, MD 21701, USA
| | - Yanzi Xiao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
| | - Vanessa Tenet
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), 150 cours Albert Thomas, CEDEX 08, 69372 Lyon, France; (G.M.C.); (V.T.)
| | - Kai Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
| | - Bin Zhu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
| | - Laurie Burdett
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, MD 21701, USA
| | - Sevilay Turan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
- Cancer Genomics Research Laboratory, Leidos Biomedical Research, Inc., Frederick, MD 21701, USA
| | - Thomas Lorey
- Regional Laboratory, Kaiser Permanente Northern California, Oakland, CA 94710, USA;
| | - Philip E. Castle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
| | - Robert D. Burk
- Departments of Pediatrics and Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA;
- Department of Epidemiology & Population Health, and Obstetrics, Gynecology and Women’s Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Lisa Mirabello
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD 20850, USA; (M.P.); (M.S.); (M.Y.); (M.C.); (J.F.B.); (M.S.); (S.B.); (Y.X.); (K.Y.); (B.Z.); (L.B.); (S.T.); (P.E.C.); (N.W.)
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He Z, Wang X, Yang Z, Jiang Y, Li L, Wang X, Song Z, Wang X, Wan J, Jiang S, Zhang N, Cui R. Expression and prognosis of CDC45 in cervical cancer based on the GEO database. PeerJ 2021; 9:e12114. [PMID: 34557356 PMCID: PMC8420875 DOI: 10.7717/peerj.12114] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/15/2021] [Indexed: 12/24/2022] Open
Abstract
Cervical cancer is one of the most common malignant tumors in women, and its morbidity and mortality are increasing year by year worldwide. Therefore, an urgent and challenging task is to identify potential biomarkers for cervical cancer. This study aims to identify the hub genes based on the GEO database and then validate their prognostic values in cervical cancer by multiple databases. By analysis, we obtained 83 co-expressed differential genes from the GEO database (GSE63514, GSE67522 and GSE39001). GO and KEGG enrichment analysis showed that these 83 co-expressed it mainly involved differential genes in DNA replication, cell division, cell cycle, etc.. The PPI network was constructed and top 10 genes with protein-protein interaction were selected. Then, we validated ten genes using some databases such as TCGA, GTEx and oncomine. Survival analysis demonstrated significant differences in CDC45, RFC4, TOP2A. Differential expression analysis showed that these genes were highly expressed in cervical cancer tissues. Furthermore, univariate and multivariate cox regression analysis indicated that CDC45 and clinical stage IV were independent prognostic factors for cervical cancer. In addition, the HPA database validated the protein expression level of CDC45 in cervical cancer. Further studies investigated the relationship between CDC45 and tumor-infiltrating immune cells via CIBERSORT. Finally, gene set enrichment analysis (GSEA) showed CDC45 related genes were mainly enriched in cell cycle, chromosome, catalytic activity acting on DNA, etc. These results suggested CDC45 may be a potential biomarker associated with the prognosis of cervical cancer.
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Affiliation(s)
- Zikang He
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Xiaojin Wang
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Zhiming Yang
- Department of Clinical Laboratory, Handan Central Hospital, Handan, China
| | - Ying Jiang
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Luhui Li
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Xingyun Wang
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Zheyao Song
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Xiuli Wang
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China.,Department of Clinical Laboratory, The Seventh Hospital in Qiqihar, Qiqihar, China
| | - Jiahui Wan
- Department of Clinical Laboratory, Harbin Public Security Hospital, Harbin, China
| | - Shijun Jiang
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China.,Department of Clinical Laboratory, Daqing Medical College, Daqing, China
| | - Naiwen Zhang
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
| | - Rongjun Cui
- Department of Biochemistry and Molecular Biology, Mudanjiang Medical University, Mudanjiang, China
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Pan Q, Meng X, Li J, Qin X, Chen H, Li Y. CircSAMD11 facilitates progression of cervical cancer via regulating miR-503/SOX4 axis through Wnt/β-catenin pathway. Clin Exp Pharmacol Physiol 2021; 49:175-187. [PMID: 34546569 DOI: 10.1111/1440-1681.13593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/29/2021] [Accepted: 09/16/2021] [Indexed: 01/15/2023]
Abstract
Cervical cancer (CC) is a common gynaecological malignant tumour with a high mortality rate. Circular RNAs (circRNAs) play a critical role in tumour occurrence and development. This study aimed to investigate the function and molecular basis of hsa_circ_0009189 (circSAMD11) in CC development. RNA levels were determined by qRT-PCR, and protein expression was measured by western blot. Cell proliferation, migration, invasion and apoptosis were detected by Cell Counting Kit-8 (CCK-8), colony formation, Transwell and flow cytometry assays. The relationship between miR-503 and circSAMD11/SOX4 was validated via dual-luciferase reporter assay, RIP or RNA pull-down assay. Xenograft assay was conducted to test tumour growth in vivo. CircSAMD11 and SOX4 levels were elevated, while miR-503 level was reduced in CC tissues and cells. Knockdown of circSAMD11 suppressed CC cell proliferation, migration and invasion and accelerated apoptosis. CircSAMD11 was localised in cytoplasm and directly targeted miR-503. Also, circSAMD11 sponged miR-503 to modulate SOX4 expression. Additionally, circSAMD11 regulated CC progression via absorbing miR-503 or modulating SOX4. Besides, depletion of circSAMD11 hindered tumorigenesis in vivo. CircSAMD11 contributed to CC progression by regulating miR-503/SOX4 signalling and activating Wnt/β-catenin pathway, which provides a promising therapeutic target for cervical cancer.
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Affiliation(s)
- Qiwen Pan
- Department of Gynaecology, Hechi Hospital Affiliated to YouJiang Medical University For Nationalities, The People's Hospital of Hechi, Hechi, China
| | - Xia Meng
- Department of Gynaecology, The First People's Hospital of Hechi, Hechi, China
| | - Jianxiang Li
- Department of Gynaecology, Hechi Hospital Affiliated to YouJiang Medical University For Nationalities, The People's Hospital of Hechi, Hechi, China
| | - Xiaoni Qin
- Department of Gynaecology, Hechi Hospital Affiliated to YouJiang Medical University For Nationalities, The People's Hospital of Hechi, Hechi, China
| | - Huifeng Chen
- Department of Gynaecology, Hechi Hospital Affiliated to YouJiang Medical University For Nationalities, The People's Hospital of Hechi, Hechi, China
| | - Yueqing Li
- Department of Gynaecology, Hechi Hospital Affiliated to YouJiang Medical University For Nationalities, The People's Hospital of Hechi, Hechi, China
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95
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Nemcova J, Cerna K, Rob F, Smahelova J, Tresnak Hercogova J, Marx J, Traxmandlova I, Ondic O. Prevalence of high-risk human papillomavirus DNA and mRNA and its association with abnormal anal cytology in the Czech male anal cancer screening cohort. Diagn Cytopathol 2021; 49:1188-1195. [PMID: 34529895 DOI: 10.1002/dc.24873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Anal cancer (AC) screening is justified in high-risk populations, particularly HIV-positive men having sex with men (MSM). HR-HPV testing could improve the efficiency of cytologically based screening of AC, as in the screening of biologically analogical cervical cancer. The specificity of HR-HPV testing is influenced by the prevalence of HR-HPV infection in the screened population. Reported anal HR-HPV DNA prevalence in MSM is high, but HR-HPV mRNA reflects rather long-term infections and is more specific for high-grade lesions. However, no data were published about HR-HPV DNA and mRNA prevalence in the Czech AC screening population. METHOD Results of liquid-based anal cytology of 203 predominantly HIV-positive MSM from the Czech AC screening cohort were correlated with results of DNA and E6/E7 mRNA testing of 14 HR-HPV types, and HPV16 genotyping. Eighty-one MSM underwent a standard anoscopy. RESULTS A total of 109 (53.7%) samples had abnormal cytology, with 12 (5.9%) ASC-H/HSIL, 67 (33.0%) samples cytologically negative, and 27 (13.3%) unsatisfactory. HR-HPV DNA was detected in 134 (66.0%) and HR-HPV RNA in 72 (35.5%) anal smears. HR-HPV mRNA and HPV16 mRNA positivity were associated with abnormal cytology (p = .0037, p = .0021). No significant association was found between HR-HPV DNA or HPV16 DNA positivity and abnormal cytology. No high-grade lesions were revealed by anoscopy. CONCLUSION Prevalence of anal HR-HPV DNA among Czech MSM is high, however, the prevalence of HR-HPV mRNA is half and associated with abnormal cytology. Our results indicate an increased efficiency of cytological screening when combined with HR-HPV mRNA testing.
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Affiliation(s)
- Jana Nemcova
- Biomedical Center of the Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Sikl's Department of Pathology, University Hospital in Pilsen, Pilsen, Czech Republic.,Biopticka Laborator s.r.o., Pilsen, Czech Republic
| | - Katerina Cerna
- Biomedical Center of the Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Sikl's Department of Pathology, University Hospital in Pilsen, Pilsen, Czech Republic.,Biopticka Laborator s.r.o., Pilsen, Czech Republic
| | - Filip Rob
- Department of Dermatovenereology, Second Faculty of Medicine, Charles University, Bulovka University Hospital, Prague, Czech Republic
| | - Jana Smahelova
- National Reference Laboratory for Papillomaviruses and Polyomaviruses, Institute Hematology and Blood Transfusion, Prague, Czech Republic
| | - Jana Tresnak Hercogova
- Department of Dermatovenereology, Second Faculty of Medicine, Charles University, Bulovka University Hospital, Prague, Czech Republic
| | - Josef Marx
- Department of Surgery, First Faculty of Medicine, Charles University, Bulovka University Hospital, Prague, Czech Republic
| | - Iva Traxmandlova
- Faculty of Education, Centre for Biology, Geoscience and Environmental Education, University of West Bohemia, Pilsen, Czech Republic.,Global Change Research Institute, Czech Academy of Science, Brno, Czech Republic
| | - Ondrej Ondic
- Biomedical Center of the Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Sikl's Department of Pathology, University Hospital in Pilsen, Pilsen, Czech Republic.,Biopticka Laborator s.r.o., Pilsen, Czech Republic
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96
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Beneteau T, Selinger C, Sofonea MT, Alizon S. Episome partitioning and symmetric cell divisions: Quantifying the role of random events in the persistence of HPV infections. PLoS Comput Biol 2021; 17:e1009352. [PMID: 34491986 PMCID: PMC8448377 DOI: 10.1371/journal.pcbi.1009352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/17/2021] [Accepted: 08/16/2021] [Indexed: 12/04/2022] Open
Abstract
Human Papillomaviruses (HPV) are one of the most prevalent sexually transmitted infections (STI) and the most oncogenic viruses known to humans. The vast majority of HPV infections clear in less than 3 years, but the underlying mechanisms, especially the involvement of the immune response, are still poorly known. Building on earlier work stressing the importance of randomness in the type of cell divisions in the clearance of HPV infection, we develop a stochastic mathematical model of HPV dynamics that combines the previous aspect with an explicit description of the intracellular level. We show that the random partitioning of virus episomes upon stem cell division and the occurrence of symmetric divisions dramatically affect viral persistence. These results call for more detailed within-host studies to better understand the relative importance of stochasticity and immunity in HPV infection clearance. Every year, infections by Human Papillomaviruses (HPV) are responsible for a large share of infectious cancers. The prevalence of HPVs is very high, which makes it a major public health issue. Fortunately, most HPV infections (80 to 90%) are cleared naturally within three years. Among the few that persist into chronic infections, the majority also naturally regress. Hence for a given HPV infection, the risk of progression towards cancerous status is low. The immune response is often invoked to explain HPV clearance in non-persisting infections, but many uncertainties remain. Besides immunity, randomness was also suggested to play an important role. Here, we examine how random events occurring during the life cycle of the virus could alter the persistence of the virus inside the host. We develop a mechanistic model that explicitly follows the dynamic of viral copies inside host cells, as well as the dynamics of the epithelium. In our model, infection extinction occurs when all viral copies end up in differentiated cells and migrate towards the surface. This can happen upon cell division during the random allocation of the episomes (i.e. independent circular DNA copies of the viral genome) or when a stem cell divides symmetrically to generate two differentiated cells. We find that the combination of these random events drastically affects infection persistence. More generally, the importance of random fluctuations could match that of immunity and calls for further studies at the within-host and the epidemiological level.
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Affiliation(s)
- Thomas Beneteau
- Laboratoire MIVEGEC, Université de Montpellier, Centre national de la recherche scientifique, Institut de recherche pour le développement, Montpellier, France
- * E-mail:
| | - Christian Selinger
- Laboratoire MIVEGEC, Université de Montpellier, Centre national de la recherche scientifique, Institut de recherche pour le développement, Montpellier, France
| | - Mircea T. Sofonea
- Laboratoire MIVEGEC, Université de Montpellier, Centre national de la recherche scientifique, Institut de recherche pour le développement, Montpellier, France
| | - Samuel Alizon
- Laboratoire MIVEGEC, Université de Montpellier, Centre national de la recherche scientifique, Institut de recherche pour le développement, Montpellier, France
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97
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Reyna-Jeldes M, Díaz-Muñoz M, Madariaga JA, Coddou C, Vázquez-Cuevas FG. Autocrine and paracrine purinergic signaling in the most lethal types of cancer. Purinergic Signal 2021; 17:345-370. [PMID: 33982134 PMCID: PMC8410929 DOI: 10.1007/s11302-021-09785-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/25/2021] [Indexed: 02/07/2023] Open
Abstract
Cancer comprises a collection of diseases that occur in almost any tissue and it is characterized by an abnormal and uncontrolled cell growth that results in tumor formation and propagation to other tissues, causing tissue and organ malfunction and death. Despite the undeniable improvement in cancer diagnostics and therapy, there is an urgent need for new therapeutic and preventive strategies with improved efficacy and fewer side effects. In this context, purinergic signaling emerges as an interesting candidate as a cancer biomarker or therapeutic target. There is abundant evidence that tumor cells have significant changes in the expression of purinergic receptors, which comprise the G-protein coupled P2Y and AdoR families of receptors and the ligand-gated ion channel P2X receptors. Tumor cells also exhibit changes in the expression of nucleotidases and other enzymes involved in nucleotide metabolism, and the concentrations of extracellular nucleotides are significantly higher than those observed in normal cells. In this review, we will focus on the potential role of purinergic signaling in the ten most lethal cancers (lung, breast, colorectal, liver, stomach, prostate, cervical, esophagus, pancreas, and ovary), which together are responsible for more than 5 million annual deaths.
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Affiliation(s)
- M Reyna-Jeldes
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
- Millennium Nucleus for the Study of Pain (MiNuSPain), Santiago, Chile
- Núcleo para el Estudio del Cáncer a nivel Básico, Aplicado y Clínico, Universidad Católica del Norte, Antofagasta, Chile
| | - M Díaz-Muñoz
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Querétaro, México
| | - J A Madariaga
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile
- Núcleo para el Estudio del Cáncer a nivel Básico, Aplicado y Clínico, Universidad Católica del Norte, Antofagasta, Chile
| | - C Coddou
- Departamento de Ciencias Biomédicas, Facultad de Medicina, Universidad Católica del Norte, Coquimbo, Chile.
- Millennium Nucleus for the Study of Pain (MiNuSPain), Santiago, Chile.
- Núcleo para el Estudio del Cáncer a nivel Básico, Aplicado y Clínico, Universidad Católica del Norte, Antofagasta, Chile.
| | - F G Vázquez-Cuevas
- Departamento de Neurobiología Celular y Molecular, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Querétaro, Querétaro, México.
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98
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Turchan WT, Liauw SL. Chemoradiation for Anal Cancer: Clinical Outcomes and Strategies to Optimize the Therapeutic Ratio According to HPV Status. Semin Radiat Oncol 2021; 31:349-360. [PMID: 34455990 DOI: 10.1016/j.semradonc.2021.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The incidence of anal cancer in the United States has increased in recent years, primarily related to the increasing incidence of HPV-associated anal squamous cell carcinoma, which is estimated to represent 80%-95% of anal cancers. Similar to head and neck cancer, HPV association has been demonstrated to be a strong positive prognostic factor in patients with anal cancer. Encouraging results from a number of studies investigating treatment de-escalation for HPV-associated oropharyngeal cancer support the notion that similar attempts may be feasible in HPV-associated anal cancer; however, the data to support this hypothesis are currently lacking. Studies are needed to determine how, if at all, HPV status should impact the management of patients with anal cancer. This review summarizes the relationship between HPV association and outcomes for patients with anal cancer, and how HPV status may impact the treatment of patients with anal cancer going forward.
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Affiliation(s)
| | - Stanley L Liauw
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL.
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99
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Understanding the Acceptability and Uptake of HPV Self-Sampling Amongst Women Under- or Never-Screened for Cervical Cancer in Toronto (Ontario, Canada): An Intervention Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179114. [PMID: 34501703 PMCID: PMC8430523 DOI: 10.3390/ijerph18179114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 11/21/2022]
Abstract
Cervical cancer remains a global public health concern, even though scientific advancements have made the disease almost entirely preventable. With the link between human papillomavirus (HPV) and cervical cancer, and the subsequent improvement in screening technology, there is potential to improve access and coverage of cervical screening with the introduction of HPV self-sampling. In Ontario, Canada, a province with a cytology-based screening program (i.e., Pap test), women who identify as South Asian, West Asian, Middle Eastern and North African have some of the lowest rates of screening, and research suggests they have a higher burden of cervical cancer. In this study, we will use both quantitative and qualitative methods to understand the acceptability and uptake of a take-home HPV self-sampling kit. Working with community champions—people with pre-existing connections with local groups—we will recruit women from these groups who are under- or never-screened for cervical cancer. Women will self-select whether they are in the group that tries HPV self-sampling or in the group that does not. We will aim for 100 women in each group. All participants will provide feedback on the feasibility, acceptability and preferences for cervical screening through a survey and phone follow-up. Women who self-select the HPV self-sampling group, will be followed up to find out if they followed through with self-sampling and to understand their experience using the device. Women who do not want to try self-sampling will be followed up to see if they went on to get a Pap test. The qualitative phase of this study consists of five focus groups with participants and semi-structured interviews with key informants in the community.
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100
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Chen C, Xu Y, Huang W, Du Y, Hu C. Natural history of histologically confirmed high-grade cervical intraepithelial neoplasia during pregnancy: meta-analysis. BMJ Open 2021; 11:e048055. [PMID: 34417214 PMCID: PMC8381303 DOI: 10.1136/bmjopen-2020-048055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES This study aimed to conduct a meta-analysis of estimates of the natural history of high-grade cervical intraepithelial neoplasia (CIN) during pregnancy. SETTING Studies examining the clinical courses of histologically confirmed high-grade CIN during pregnancy. PARTICIPANTS We searched PubMed, Web of Science and Embase for eligible studies. Studies were included if they reported the data regarding the natural history of histologically confirmed high-grade CIN during pregnancy. Final estimates were from the meta-analysis of 10 eligible studies. PRIMARY OUTCOME MEASURES The regression rate, persistence rate and progression rate of histologically proven untreated high-grade CIN during pregnancy. RESULTS A total of 10 original studies were included in this meta-analysis. During pregnancy, the regression rate, persistence rate and progression rate of high-grade CIN were 40% (95% CI 35% to 45%), 59% (95% CI 54% to 64%) and 1% (95% CI 0% to 2%), respectively. There was moderate heterogeneity among the studies. The results of the subgroup meta-analysis show that the pooled rates of regression and persistence during pregnancy were 59% (95% CI 54% to 65%) and 40% (95% CI 35% to 45%) for CIN2, and 29% (95% CI 25% to 33%) and 70% (95% CI 65% to 73%) for CIN3. CONCLUSIONS During pregnancy, the majority of histologically confirmed high-grade CIN would be persistent or regressed to lower grade CIN or normal. However, it is still worth noting that a small percentage of high-grade CIN would progress to cervical cancer during pregnancy.
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Affiliation(s)
- Cheng Chen
- Department of Obstetrics and Gynaecology, Pidu District People's Hospital, Chengdu, China
- Department of Obstetrics and Gynaecology, The Third Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yu Xu
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Wu Huang
- Department of Obstetrics and Gynaecology, Pidu District People's Hospital, Chengdu, China
- Department of Obstetrics and Gynaecology, The Third Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yi Du
- Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Cui Hu
- Department of Obstetrics and Gynaecology, People's Hospital of Mianzhu City, Deyang, China
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