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Agudelo MC, Torres-González E, Agudelo S, Ramírez AT, Castañeda KM, Kinslow CJ, Rodríguez-Herrera M, Garland L, Xie Y, Orozco CA, Stoler M, Dean M, Sánchez GI. Comparison of Hybribio-H13 and Hybrid Capture® 2 human papillomavirus tests for detection of CIN2+ and CIN3. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2024; 44:101-109. [PMID: 39079144 DOI: 10.7705/biomedica.7061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 03/13/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Low-cost, accurate high-risk HPV tests are needed for cervical cancer screening in limited-resource settings. OBJECTIVE To compare the performance of the low-cost Hybribio-H13 test with the Hybrid Capture® 2 to detect cervical intraepithelial neoplasia grade 2 or 3 (CIN2 and CIN3). MATERIALS AND METHODS Archived baseline samples tested by the Hybrid Capture® 2 from women of the ASCUS-COL trial, aged 20 to 69 years, with biopsy-colposcopy directed diagnosis of CIN2+ (n = 143), CIN3+ (n = 51), and < CIN2 (n = 632) were blindly tested by the Hybribio-H13 test. RESULTS The relative sensitivity of the Hybribio-H13 test versus the Hybrid Capture® 2 for detecting CIN2+ was 0.89 (90% CI = 0,80-0,98; NIT = 0,66), and for CIN3+ was 0,92 (90% CI = 0,85-0,98; NIT = 0,35). Relative specificity was 1.19 (90% CI = 1.05-1.33; NIT <0.00001). In the analysis restricted to women older than 30 years, the relative sensitivity of the Hybribio-H13 for CIN3+ was marginally below unity (ratio = 0.97; 90% CI = 0.95-0.99), and the specificity remained higher than the Hybrid Capture® 2 test. CONCLUSION The Hybribio-H13 test was as specific as the Hybrid Capture® 2 for detecting CIN2+ or CIN3+ but less sensitive. Considering these results and the young age of the population recruited for screening because of ASCUS cytology, we suggest our results warrant the evaluation of the Hybribio-H13 for screening cervical cancer, especially in the evaluated population.
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Affiliation(s)
- María Cecilia Agudelo
- Grupo Infección y Cáncer, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Edmundo Torres-González
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Gaithersburg, MD, USA
| | - Samuel Agudelo
- Grupo Infección y Cáncer, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Arianis Tatiana Ramírez
- Grupo Infección y Cáncer, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Kelly Melisa Castañeda
- Grupo Infección y Cáncer, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Connor J Kinslow
- Department of Radiation Oncology, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA
| | - María Rodríguez-Herrera
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Gaithersburg, MD, USA
| | - Lisa Garland
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Gaithersburg, MD, USA
| | - Yi Xie
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Gaithersburg, MD, USA
| | - Carlos Alberto Orozco
- Grupo Infección y Cáncer, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mark Stoler
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - Michael Dean
- Laboratory of Translational Genomics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Gaithersburg, MD, USA
| | - Gloria Inés Sánchez
- Grupo Infección y Cáncer, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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Agudelo MC, Agudelo S, Lorincz A, Ramírez AT, Castañeda KM, Garcés-Palacio I, Zea AH, Piyathilake C, Sanchez GI. Folate deficiency modifies the risk of CIN3+ associated with DNA methylation levels: a nested case-control study from the ASCUS-COL trial. Eur J Nutr 2024; 63:563-572. [PMID: 38129362 PMCID: PMC10899296 DOI: 10.1007/s00394-023-03289-4] [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: 07/17/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To our knowledge, there are very few studies evaluating if the levels of folate modify the risk of cervical intraepithelial neoplasia grade 2 and higher (CIN2+ and CIN3+) associated with the levels of HPV genome methylation, two cofactors related to single carbon metabolism and independently associated with cervical cancer in previous studies. We conducted a case-control study nested in a three-arm randomized clinical pragmatic trial (ASCUS-COL trial) to evaluate the risk of CIN3+ associated with methylation levels according to serum folate concentrations. METHODS Cases (n = 155) were women with histologically confirmed CIN2+ (113 CIN2, 38 CIN3, and 4 SCC) and controls were age and follow-up time at diagnosis-matched women with histologically confirmed ≤ CIN1 (n = 155), selected from the 1122 hrHPV + women of this trial. The concentrations of serum folate were determined by the radioimmunoassay SimulTRAC-SNB-VitaminB12/Folate-RIAKit and the methylation levels by the S5 classifier. Stepwise logistic regression models were used to estimate the association between folate or methylation levels and CIN2+ or CIN3+. The joint effect of folate levels and methylation on the risk of CIN3+ was estimated using combinations of categorical stratifications. RESULTS Folate levels were significantly lower in women with CIN3+ than in other diagnostic groups (p = 0.019). The risk of CIN3+ was eight times higher (OR 8.9, 95% CI 3.4-24.9) in women with folate deficiency and high methylation levels than in women with normal folate and high methylation levels (OR 1.4, 95% CI 0.4-4.6). CONCLUSION High methylation and deficient folate independently increased the risk of CIN3+ while deficient folate combined with high methylation was associated with a substantially elevated risk of CIN3+.
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Affiliation(s)
- María C Agudelo
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Carrera 51D No 62-29, 050010, Medellín, Colombia
| | - Samuel Agudelo
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Carrera 51D No 62-29, 050010, Medellín, Colombia
| | - Attila Lorincz
- Centre for Cancer Prevention, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Arianis Tatiana Ramírez
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Carrera 51D No 62-29, 050010, Medellín, Colombia
- Postdoctoral Fellow at the Prevention and Implementation Group, International Agency for Research On Cancer/World Health Organization, Lyon, France
| | - Kelly Melisa Castañeda
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Carrera 51D No 62-29, 050010, Medellín, Colombia
| | - Isabel Garcés-Palacio
- Epidemiology Group, School of Public Health, Universidad de Antioquia, Medellín, Colombia
| | - Arnold H Zea
- Stanley S. Scott Cancer Center, Microbiology, Immunology and Parasitology, LSU Health Sciences Center, New Orleans, USA
| | - Chandrika Piyathilake
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, USA
| | - Gloria Ines Sanchez
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Carrera 51D No 62-29, 050010, Medellín, Colombia.
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de Velozo G, Cordeiro J, Sousa J, Holanda AC, Pessoa G, Porfírio M, Távora F. Comparison of glass and digital slides for cervical cytopathology screening and interpretation. Diagn Cytopathol 2023; 51:735-743. [PMID: 37587842 DOI: 10.1002/dc.25209] [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: 05/22/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/18/2023]
Abstract
Cervical cancer is the second most common form of cancer and a leading cause of premature death among women aged 15 to 44 worldwide. In Brazil, there is a high prevalence of infection by the human papillomavirus - HPV. Digital pathology optimizes time and space for reading cervicovaginal cytology slides. We evaluated the feasibility of using whole slide images (WSI) for the routine interpretation of cytology exams. A total of 99 cases of vaginal cytology were selected from a reference laboratory in Northeastern Brazil. Three cytotechnicians participated in the study. Cellular atypia was the one that most presented concordance values. Two observers almost perfectly agreed (k = 0.86 and k = 0.84, respectively) on the negative diagnoses. The performance of the evaluators for NILM (negative for intraepithelial lesion and malignancy) showed high reproducibility and sensitivity in the digital slides, mainly between evaluators A and C. In contrast, the microbiology group showed disagreement between the diagnoses by digital slides and the standard- gold. The concordance between the digital diagnoses and the gold standard for ASCUS was 89%. In the inflammatory category, Spearman's test showed similar results between raters A, B, and C (rs = 0.47, rs = 0.41, and rs = 0.47, respectively). This study reports the diagnostic validation using digital slides in view of the need to optimize the cytology visualization process. Our experience shows good diagnostic agreement between digital and optical microscopy in several analyzed categories, but mainly in relation to cellular atypia and inflammatory processes.
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Affiliation(s)
| | - Juliana Cordeiro
- Federal University of Ceará, Argos Patologia Laboratory, Fortaleza, Brazil
| | | | | | | | - Mônica Porfírio
- Federal University of Ceará, Argos Patologia Laboratory, Fortaleza, Brazil
| | - Fábio Távora
- Federal University of Ceará, Argos Patologia Laboratory, Fortaleza, Brazil
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González-Ramírez MI, Cardona YT, Agudelo MC, López C, Florez-Acosta JJ, Agudelo-Gamboa S, Garai J, Li L, Orozco-Castaño CA, Zabaleta J, Sánchez GI. miRNAs signature as potential biomarkers for cervical precancerous lesions in human papillomavirus positive women. Sci Rep 2023; 13:9822. [PMID: 37330541 PMCID: PMC10276834 DOI: 10.1038/s41598-023-36421-9] [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: 11/29/2022] [Accepted: 06/03/2023] [Indexed: 06/19/2023] Open
Abstract
Biomarkers to identify women at risk of cervical cancer among those with high-risk HPV infection (hrHPV+) are needed. Deregulated expression of microRNAs (miRNAs) contributes to hrHPV-induced cervical carcinogenesis. We aimed at identifying miRNAs with the capacity to distinguish high (CIN2+) and low (≤ CIN1) grade cervical lesions. We sequenced miRNA libraries from Formalin-Fixed Paraffin-Embedded (FFPE) tissues from women with CIN2+ (n = 10) and age-matched women with ≤ CIN1 (n = 10), randomly and retrospectively selected from a trial that followed women for 24 months after a hrHPV+ test at the screening visit. Five miRNAs differentially expressed were validated by RT-qPCR in an independent set of FFPE tissues with a reviewed diagnosis of CIN2+ (n = 105) and ≤ CIN1 (n = 105). The Ingenuity Pathway Analysis (IPA) was conducted to identify mRNAs inversely correlated with the top 25 differentially expressed miRNAs. Inverse correlations with 401 unique mRNA targets were identified for fourteen of the top 25 differentially expressed miRNAs. Eleven of these miRNAs targeted 26 proteins of pathways deregulated by HPV E6 and E7 oncoproteins and two of them, miR-143-5p and miR-29a-3p, predicted CIN2+ and CIN3+ in the independent validation by RT-qPCR of FFPE tissues from hrHPV-positive women.
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Affiliation(s)
- Martha I González-Ramírez
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Cra 51D No 62-29 Lab 219, Medellín, 050010, Antioquia, Colombia
| | - Yurley T Cardona
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Cra 51D No 62-29 Lab 219, Medellín, 050010, Antioquia, Colombia
| | - María C Agudelo
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Cra 51D No 62-29 Lab 219, Medellín, 050010, Antioquia, Colombia
| | - Carolina López
- Department of Pathology, Universidad de Antioquia, Medellín, 050010, Antioquia, Colombia
| | - Juan J Florez-Acosta
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Cra 51D No 62-29 Lab 219, Medellín, 050010, Antioquia, Colombia
| | - Samuel Agudelo-Gamboa
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Cra 51D No 62-29 Lab 219, Medellín, 050010, Antioquia, Colombia
| | - Jone Garai
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Li Li
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Carlos A Orozco-Castaño
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Cra 51D No 62-29 Lab 219, Medellín, 050010, Antioquia, Colombia
- School of Health and Sport Sciences, Fundación Universitaria del Área Andina, Bogotá, 110111, Cundinamarca, Colombia
| | - Jovanny Zabaleta
- Stanley S. Scott Cancer Center, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
- Department of Interdisciplinary Oncology, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Gloria I Sánchez
- Infection and Cancer Group, School of Medicine, Universidad de Antioquia, Cra 51D No 62-29 Lab 219, Medellín, 050010, Antioquia, Colombia.
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Ramírez AT, Sánchez GI, Nedjai B, Agudelo MC, Brentnall AR, Cuschieri K, Castañeda KM, Cuzick J, Lorincz AT. Effective methylation triage of HPV positive women with abnormal cytology in a middle-income country. Int J Cancer 2021; 148:1383-1393. [PMID: 33006394 DOI: 10.1002/ijc.33314] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/20/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022]
Abstract
The S5-methylation test, an alternative to cytology and HPV16/18 genotyping to triage high-risk HPV-positive (hrHPV+) women, has not been widely validated in low-middle-income countries (LMICs). We compared S5 to HPV16/18 and cytology to detect cervical intraepithelial neoplasia Grade 2 or worse (CIN2+) and CIN3+ in hrHPV+ women selected from a randomized pragmatic trial of 2661 Colombian women with an earlier-borderline abnormal cytology. We included all hrHPV+ CIN2 and CIN3+ cases (n = 183) age matched to 183
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Affiliation(s)
- Arianis Tatiana Ramírez
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, Medellín, Colombia
| | - Gloria Inés Sánchez
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, Medellín, Colombia
| | - Belinda Nedjai
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - María Cecilia Agudelo
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, Medellín, Colombia
| | - Adam R Brentnall
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Kate Cuschieri
- Queen's Medical Research Institute of The University of Edinburgh, Edinburgh, UK
| | - Kelly Melisa Castañeda
- Infection and Cancer Group, School of Medicine and Corporación Académica para el Estudio de Patologías Tropicales, Universidad de Antioquia, Medellín, Colombia
| | - Jack Cuzick
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Attila T Lorincz
- Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, London, UK
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