1
|
Lower accuracy of cytological screening for high-grade squamous intraepithelial neoplasia in women over 50 years of age in Japan. Int J Clin Oncol 2021; 27:427-433. [PMID: 34873649 PMCID: PMC8816739 DOI: 10.1007/s10147-021-02065-w] [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: 06/20/2021] [Accepted: 10/25/2021] [Indexed: 11/26/2022]
Abstract
Background As the population ages in developed countries, the number of Pap smears for cervical cancer screening of older women is increasing. There is concern that cervical atrophy may cause misinterpretation of results for this segment of the population. The present study evaluated the accuracy of screening for high-grade intraepithelial lesions (HSILs) in women younger or older than 50 years, to determine whether aging affects cytological interpretation. Methods Patients with HSIL cytology (N = 1565) were dichotomized into those aged 20–49 years or aged ≥ 50 years. Association between histology results and age was examined. Pearson’s chi-squared test and Cochran-Armitage trend test were used for statistical analysis. Results The positive predictive value (PPV) for cervical intraepithelial neoplasia (CIN)2 and worse was 65.2% (62/95) in older women but 87.3% (482/552) in younger women (p < 0.001). Older patients had a significantly lower PPV (p = 1.69 × 10–8). Separately analyzing chronic cervicitis, CIN1 and overt cancer grouped together, compared with another group composed of CIN2 and CIN3, we found that the PPV for CIN2 and CIN3 was lower in older than in younger women [44.2% (42/95)-vs-82.4% (455/552), p < 0.001], respectively. Conclusions HSILs are associated with a wide range of disease categories as age increases, and the accuracy of HSIL interpretation is lower in older women. Supplementary Information The online version contains supplementary material available at 10.1007/s10147-021-02065-w.
Collapse
|
2
|
El-Zein M, Gotlieb W, Gilbert L, Hemmings R, Behr MA, Franco EL. Dual staining for p16/Ki-67 to detect high-grade cervical lesions: Results from the Screening Triage Ascertaining Intraepithelial Neoplasia by Immunostain Testing study. Int J Cancer 2020; 148:492-501. [PMID: 32781481 DOI: 10.1002/ijc.33250] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/13/2020] [Accepted: 08/03/2020] [Indexed: 12/13/2022]
Abstract
We compared clinical performance of p16/Ki-67 dual-stained cytology and human papillomavirus (HPV) genotyping, via different algorithms-alone, or in combination with cytology-to identify cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and grade 3 or worse (CIN3+) in women referred to as colposcopy. We included 492 cervical specimens (134 normal, 130 CIN1, 99 CIN2, 121 CIN3, 8 cancers) randomly selected from 1158 specimens with valid conventional cytology, HPV (cobas 4800 HPV test) and biopsy results. Dual-stained cytology was retrospectively performed (CINtec PLUS assay) on PreservCyt material; slides were read by a cytologist and confirmed by two pathologists, blinded to cytology, biopsy and genotyping results. Sensitivity and specificity (95% confidence intervals in parentheses) of dual-stained cytology to detect CIN2+ and CIN3+ were compared to other screening tests available for the same women. Positivity rate for dual-stained cytology increased with histological severity: 30.6% in normal, 41.5% in CIN1, 72.7% in CIN2, 86.8% in CIN3 and 87.5% in cancer. Dual-stained cytology alone had lower sensitivity than HPV testing for CIN2+ [80.7% (75.0-85.6) vs 89.9% (85.3-93.5)] and CIN3+ [86.8% (79.7-92.1) vs 92.3% (86.2-96.2)]. However, corresponding specificity values were higher [64.0% (57.9-69.8) vs 56.1% (49.8-62.1) for CIN2+; 54.0% (48.7-59.2) vs 44.4% (39.2-49.6) for CIN3+]. Combining dual-stained cytology with an ASC-US abnormality threshold decreased specificity to 31.4% (25.9-37.4) for CIN2+ and 24.2% (19.9-29.0) for CIN3+. The corresponding values considering low squamous intraepithelial lesion threshold values were 42.8% (36.8-49.0) and 35.0% (30.1-40.1). Dual-stained cytology and HPV testing exhibited similar performance, although the former improved the specificity by 7.9% and 9.6% for CIN2+ and CIN3+, respectively.
Collapse
Affiliation(s)
- Mariam El-Zein
- Division of Cancer Epidemiology, McGill University, Montréal, Quebec, Canada
| | - Walter Gotlieb
- Division of Gynecologic Oncology and Colposcopy, McGill University-Jewish General Hospital, Montréal, Quebec, Canada
| | - Lucy Gilbert
- Gynecologic Cancer Service, McGill University Health Centre-Glen Site Cedars Cancer Centre, Montréal, Quebec, Canada
| | - Robert Hemmings
- Department of Obstetrics and Gynecology, McGill University Health Centre-St Mary's Hospital Centre, Montréal, Quebec, Canada
| | - Marcel A Behr
- Department of Medicine, McGill University Health Centre, Montréal, Quebec, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montréal, Quebec, Canada
| | | |
Collapse
|
3
|
Jiang Y, Zhu C, He D, Gao Q, Tian X, Ma X, Wu J, Das BC, Severinov K, Hitzeroth II, Debata PR, Liu R, Zou L, Shi L, Xu H, Wang K, Bao Y, Ka-Kit LR, You Z, Cui Z, Hu Z. Cytological Immunostaining of HMGA2, LRP1B, and TP63 as Potential Biomarkers for Triaging Human Papillomavirus-Positive Women. Transl Oncol 2019; 12:959-967. [PMID: 31102921 PMCID: PMC6525307 DOI: 10.1016/j.tranon.2019.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 04/16/2019] [Accepted: 04/16/2019] [Indexed: 01/17/2023] Open
Abstract
Background: Since human papillomavirus (HPV) DNA testing has been promoted as primary screening strategy, the triage method has also evolved from morphological testing to a molecular biomarker detection to improve screening efficiency. In this study, we investigated the performance of three HPV integration hot-spots, HMGA2, LRP1B, and TP63, as potential triage markers in HPV screening tests. Materials and Methods: This cross-sectional study was conducted from November 2016 to December 2017 in the First Affiliated Hospital of Sun Yat-sen University. Immunocytochemistry was carried out using residual cervical cell samples from 121 HPV-positive cases (23 normal, 24 cervical intraepithelial neoplasia (CIN) 1, and 74 CIN2+). Results: Of the 121 cases, 77 showed completely paired for the three biomarkers. In these 77 cases, receiver operating characteristic (ROC) analysis of HMGA2 showed the best potential for detecting CIN2+ among HPV+ cases (sensitivity 70%; specificity 91.89%; AUC 0.839). TP63 was second most effective biomarker (AUC 0.838; sensitivity 80%; specificity 81.08%). In contrast, LRP1B had the smallest AUC (0.801) among the three biomarkers but had the highest sensitivity (90%) and specificity (56.76%). To test the triage value of combining the three biomarkers, logistic regression was conducted followed by ROC comparison analysis. Promisingly, the combination of the three biomarkers gave the largest AUC of 0.951 with 92.5% sensitivity and 89.1% specificity (P < .0001 compared to liquid-based cytology test by Z-test). Conclusions: A combination of HMGA2, LRP1B, and TP63 as potential biomarkers may be useful for screening during triage of HPV-positive patients, particularly for detecting CIN2 + .
Collapse
Affiliation(s)
- Yunhui Jiang
- Department of Pathology, Jingmen No.2 People's Hospital/Institute for Cancer Prevention and Treatment,Jingchu University of Technology, Jingmen, Hubei Province, 448000, China.
| | - Chengyi Zhu
- Department of Obstetrics & Gynecology, Dongfeng Hospital, Hubei University of Medicine, Shiyan, Hubei Province, 442008, China.
| | - Dan He
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2(nd) Road, Yuexiu, Guangzhou, Guangdong Province, 510080, China.
| | - Qinglei Gao
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
| | - Xun Tian
- Central Hospital of Wuhan City, Huazhong University of Science and Technology, PR China.
| | - Xin Ma
- Department of Urology, The General Hospital of the People's Liberation Army, Beijing, China.
| | - Jun Wu
- School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
| | - Bhudev C Das
- Amity Institute of Molecular Medicine & Stem Cell Research, Amity University Uttar Pradesh, Sector-125, Noida, India.
| | - Konstantin Severinov
- Skolkovo Institute of Science and Technology, 100 Novaya str., Skolkovo, Moscow Region, Russia.
| | - Inga Isabel Hitzeroth
- E. Rybicki's Biopharming Research Unit. 11 Clifford Avenue, Vredehoek, 8001, Cape Town, South Africa.
| | | | - Rong Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
| | - Liang Zou
- Jingmen No.2 People's Hospital, Jingmen, Hubei Province, China..
| | - Long Shi
- Jingmen No.2 People's Hospital, Jingmen, Hubei Province, China..
| | - Hua Xu
- Jingmen No.2 People's Hospital, Jingmen, Hubei Province, China..
| | - Kaixiu Wang
- Jingmen No.2 People's Hospital, Jingmen, Hubei Province, China..
| | | | - Leung Ross Ka-Kit
- School of Public Health, The University of Hong Kong, Hong Kong, SAR, Dongguan Maternal and Child Hospital.
| | - Zeshan You
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, Yuexiu, Guangzhou, Guangdong Province, 510080, China.
| | - Zifeng Cui
- Department of Obstetrics and Gynecology, Precision Medicine Institute, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, Yuexiu, Guangzhou, Guangdong Province, 510080, China.
| | - Zheng Hu
- Department of Obstetrics and Gynecology, Precision Medicine Institute, The First Affiliated Hospital of Sun Yat-sen University, Zhongshan 2nd Road, Yuexiu, Guangzhou, Guangdong Province, 510080, China; Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, China.
| |
Collapse
|
4
|
Peeters E, Wentzensen N, Bergeron C, Arbyn M. Meta-analysis of the accuracy of p16 or p16/Ki-67 immunocytochemistry versus HPV testing for the detection of CIN2+/CIN3+ in triage of women with minor abnormal cytology. Cancer Cytopathol 2019; 127:169-180. [PMID: 30811902 DOI: 10.1002/cncy.22103] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 01/02/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Women with atypical squamous cells of undetermined significance (ASC-US) can be triaged accurately with a high-risk human papillomavirus (hrHPV) test to identify those who need a referral. However, the triage of low-grade squamous intraepithelial lesion (LSIL) with hrHPV testing has very low specificity. Overexpression of p16, with or without Ki-67, indicates neoplastic transformation of human papillomavirus-infected cervical cells and may more accurately predict underlying cervical intraepithelial neoplasia of grade 3 or worse (CIN3+). METHODS A literature search was conducted in 3 bibliographic databases. Studies were selected if they included women with ASC-US or LSIL who were triaged with dual staining (p16/Ki-67) and/or p16 staining and, if available, with a comparator hrHPV test to detect cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) or CIN3+. RESULTS Thirty-eight studies were eligible. The sensitivity of p16 staining for CIN3+ was significantly lower than that of hrHPV DNA testing (ratio for ASC-US, 0.87; 95% confidence interval [CI], 0.78-0.97; ratio for LSIL, 0.86; 95% CI, 0.80-0.93). In contrast, the specificity of p16 staining was substantially higher with relative specificities of 1.60 (95% CI, 1.35-1.88) and 2.29 (95% CI, 2.05-2.56) for ASC-US and LSIL respectively. Dual staining was as sensitive as hrHPV DNA testing but was more specific (ratio for ASC-US, 1.65; 95% CI, 1.42-1.92; ratio for LSIL, 2.45; 95% CI, 2.17-2.77). CONCLUSIONS This meta-analysis confirms that p16 staining and p16/Ki-67 staining are more specific for CIN2+/CIN3+ than hrHPV DNA testing. Although p16 staining is less sensitive for CIN3+ than hrHPV DNA testing, dual staining has similar sensitivity.
Collapse
Affiliation(s)
- Eliana Peeters
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
| | - Nicolas Wentzensen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | | | - Marc Arbyn
- Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium
| |
Collapse
|
5
|
Zhang R, Ge X, You K, Guo Y, Guo H, Wang Y, Geng L. p16/Ki67 dual staining improves the detection specificity of high-grade cervical lesions. J Obstet Gynaecol Res 2018; 44:2077-2084. [PMID: 30094887 DOI: 10.1111/jog.13760] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/22/2018] [Indexed: 01/25/2023]
Abstract
AIM The goal of this study was to analyze the specificity of p16/Ki67 dual staining in the detection of high-grade cervical lesions. METHODS A total of 223 patients with an average age of 39 years old were enrolled in this study. All samples were analyzed by p16/Ki67 immunocytochemical dual staining, liquid-based cytology and high-risk human papillomavirus (HR-HPV) test. Diagnosis of each patient was verified by histopathological test. RESULTS The specificity of p16/Ki67 dual staining was 68.33%, which was significantly higher than that of cytology (38.33%) and HR-HPV test (21.67%) (P < 0.05) for CIN2+ detection. p16/Ki67 dual staining had similar sensitivity with HR-HPV test for CIN2+ detection (90.18% vs 93.87%, P = 0.286). In atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) cases, the specificity of p16/Ki67 dual staining was significantly higher than that of HPV test (66.67% vs 3.70%, P < 0.05) and its sensitivity was similar to that of HPV test for CIN2+ detection. The sensitivity and specificity of dual staining for CIN2+ detection in HR-HPV positive women were 90.85% and 70.21%, respectively, which were higher than those of cytology (83.01% and 42.55%) and HPV16/18 test (70.59% and 44.68%). CONCLUSIONS p16/Ki67 dual staining could improve the specificity of high-grade cervical lesions detection and have similar sensitivity to HPV test for CIN2+ detection. When triaging women with ASC-US or LSIL liquid-based cytology, compared with positive HR-HPV, the specificity of CIN2+ lesion detection was increased by p16/Ki67 dual staining. p16/Ki67 dual staining could reduce colposcopy referrals and avoid excessive diagnosis and treatment.
Collapse
Affiliation(s)
- Ruiyi Zhang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Xuefei Ge
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Ke You
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yanli Guo
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Hongyan Guo
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yanjie Wang
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Li Geng
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| |
Collapse
|
6
|
Silva DC, Gonçalves AK, Cobucci RN, Mendonça RC, Lima PH, Cavalcanti G. Immunohistochemical expression of p16, Ki-67 and p53 in cervical lesions - A systematic review. Pathol Res Pract 2017; 213:723-729. [PMID: 28554769 DOI: 10.1016/j.prp.2017.03.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 03/02/2017] [Accepted: 03/04/2017] [Indexed: 11/19/2022]
Abstract
This study evaluated the immunohistochemical (IHC) expression of p16, p53 and Ki-67 in precancerous lesions and in cervical cancer (CC). Identification and review of publications assessing IHC expression in cervical intraepithelial neoplasia (CIN) and CC until February 15, 2017. Systematic review of studies in women with and without cervical lesions in order to evaluate whether there is overexpression of these biomarkers. A total of 28 publications met the criteria which included 6005 patients. The analysis showed that there is higher IHC expression of these biomarkers associated with the more severe lesions. Nineteen out of 22 evaluated studies have shown that there is a higher p16 expression in more severe lesions (CC), while in p53 expression only 4 out of the 9 studies showed a higher expression among more severe cases. Regarding the Ki-67 expression, it was observed that 9 out of 14 studies showed higher expression in more severe lesions. A complete absence of or just minimal IHC expression was observed in the normal cervical epithelium, whilst a significant increase in the expression of these biomarkers was detected according to the severity of lesions. Results suggest that these biomarkers can be considered useful tools for discriminating between the stages of the progressive cervical disease.
Collapse
Affiliation(s)
- Daliana Caldas Silva
- Health Science Post Graduation Program, Universidade Federal do Rio Grande do Norte - UFRN, Natal, RN, Brazil.
| | - Ana Katherine Gonçalves
- Health Science Post Graduation Program, Universidade Federal do Rio Grande do Norte - UFRN, Natal, RN, Brazil
| | - Ricardo Ney Cobucci
- Gynaecology and Obstetrics Department, Universidade Potiguar - UnP, Natal, RN, Brazil
| | - Roberta Cecília Mendonça
- Januário Cicco Maternity School, Universidade Federal do Rio Grande do Norte - UFRN, Natal, RN, Brazil
| | - Paulo Henrique Lima
- Januário Cicco Maternity School, Universidade Federal do Rio Grande do Norte - UFRN, Natal, RN, Brazil
| | - Geraldo Cavalcanti
- Health Science Post Graduation Program, Universidade Federal do Rio Grande do Norte - UFRN, Natal, RN, Brazil
| |
Collapse
|
7
|
|
8
|
Ovestad IT, Dalen I, Hansen E, Loge JLD, Dybdahl BM, Dirdal MB, Moltu P, Berland JM. Clinical value of fully automated p16/Ki-67 dual staining in the triage of HPV-positive women in the Norwegian Cervical Cancer Screening Program. Cancer Cytopathol 2016; 125:283-291. [DOI: 10.1002/cncy.21807] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/10/2016] [Accepted: 11/10/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Irene T. Ovestad
- Department of Pathology; Stavanger University Hospital; Stavanger Norway
| | - Ingvild Dalen
- Section of Biostatistics, Department of Research, Stavanger University Hospital; Stavanger Norway
| | - Elisabeth Hansen
- Department of Pathology; Stavanger University Hospital; Stavanger Norway
| | - Janne L. D. Loge
- Department of Pathology; Stavanger University Hospital; Stavanger Norway
| | - Britt Mona Dybdahl
- Department of Pathology; Stavanger University Hospital; Stavanger Norway
| | - Marius B. Dirdal
- Department of Clinical Medicine; Faculty of Medicine and Dentistry, University of Bergen; Bergen Norway
| | - Pia Moltu
- Department of Pathology; Stavanger University Hospital; Stavanger Norway
| | | |
Collapse
|
9
|
Chen CC, Huang LW, Bai CH, Lee CC. Predictive value of p16/Ki-67 immunocytochemistry for triage of women with abnormal Papanicolaou test in cervical cancer screening: a systematic review and meta-analysis. Ann Saudi Med 2016; 36:245-51. [PMID: 27478909 PMCID: PMC6074396 DOI: 10.5144/0256-4947.2016.245] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The Papanicolaou (Pap) test is one screening strategy used to prevent cervical cancer in developed countries. The p16/Ki-67 immunocytochemistry is a triage test performed on Pap smears in women with atypical squamous cells of undetermined significance (ASCUS) or low grade squamous intraepithelial lesion. OBJECTIVE Our objective was to review studies investigating the diagnostic performance of p16/Ki-67 dual stain for triage of women with abnormal Pap tests. DESIGN We conducted a systematic review and meta-analysis of diagnostic test accuracy studies. SETTINGS We followed the protocol of systematic review of diagnostic accuracy studies. PATIENTS AND METHODS We searched PubMed, The Cochrane Library, BioMed Central, and ClinicalTrials.gov for relevant studies. We included research that assessed the accuracy of p16/Ki-67 dual stain and high risk human papillomavirus testing for triage of abnormal Pap smears. Review articles and studies that provided insufficient data to construct 2.2 tables were excluded. Data synthesis was conducted using a random-effects model. MAIN OUTCOME MEASURES Sensitivity and specificity. RESULTS In seven studies encompassing 2628 patients, the pooled sensitivity and specificity of p16/Ki-67 for triage of abnormal Pap smear results were 0.91 (95% CI, 0.89 to 0.93) and 0.64 (95% CI, 0.62 to 0.66), respectively. No study used a case-control design. A subgroup analysis involving liquid-based cytology showed a sensitivity of 0.91 (95%CI, 0.89 to 0.93) and specificity of 0.64 (95%CI, 0.61 to 0.66). CONCLUSIONS Our meta-analysis of p16/Ki-67 dual stain studies showed that the test achieved high sensitivity and moderate specificity for p16/Ki-67 immunocytochemistry for high-grade squamous intraepi.thelial lesion and cervical cancer. We suggest that p16/Ki-67 dual stain might be a reliable ancillary method identifying high-grade squamous intraepithelial lesions in women with abnormal Pap tests. LIMITATIONS No study in the meta-analysis examined the accuracy of the p16/Ki-67 dual stain for inter.pretation of glandular neoplasms.
Collapse
Affiliation(s)
- Cheng-Chieh Chen
- Dr. Chin-Cheng Lee, Department of Pathology and Laboratory Medicine,, Shin Kong Wu Ho-Su Memorial Hospital,, No. 95, Wen Change Road, Shih Lin District,, Taipei City, Taipei, 111 Taiwan, T: 886-2-28332211 ext. 2121,, F: 886-2-28389360, , ORCID: http://orcid.org/0000-0002-3064-5016
| | | | | | - Chin-Cheng Lee
- Dr. Chin-Cheng Lee, Department of Pathology and Laboratory Medicine,, Shin Kong Wu Ho-Su Memorial Hospital,, No. 95, Wen Change Road, Shih Lin District,, Taipei City, Taipei, 111 Taiwan, T: 886-2-28332211 ext. 2121,, F: 886-2-28389360, , ORCID: http://orcid.org/0000-0002-3064-5016
| |
Collapse
|
10
|
Khunamornpong S, Settakorn J, Sukpan K, Srisomboon J, Intaraphet S, Siriaunkgul S. High performance of combined HPV testing and genotyping for HPV16/18/52/58 in triaging women with minor cervical cytological abnormalities in northern Thailand. J Med Virol 2015; 88:135-43. [PMID: 26129775 DOI: 10.1002/jmv.24290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2015] [Indexed: 11/06/2022]
Abstract
Human papillomavirus (HPV) infection is an important cause of cervical cancer. Screening with cytology or combined cytology and HPV testing helps to detect early cervical cancers and precancerous lesions (high-grade squamous intraepithelial lesion or worse [HSIL+]). Minor cytological abnormalities (atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesion) account for the majority of abnormal cervical cytology results, but only 10-20% of women with minor cytological abnormalities have histologic HSIL+. Triage tests are useful to identify the high-risk patients and reduce the colposcopy burden. This study was aimed to evaluate the triage performance of combined HPV DNA testing and genotyping. Cervical samples from women with minor cytological abnormalities, who underwent colposcopy at Chiang Mai University Hospital in northern Thailand between October 2010 and February 2014, were tested for HPV DNA using Hybrid Capture 2 (HC2). Genotyping was performed using Linear Array assay. Of 223 women with cervical histology confirmation, histologic HSIL+ was detected in 25 women (11.2%). The sensitivity, specificity, positive predictive value, and negative predictive value of 3 triage methods for histologic HSIL+ were; 100%, 47.5%, 19.4%, and 100% by HC2 only; 40.0%, 88.4%, 30.3%, and 92.1% by combined HC2 and genotypes HPV16/18; and 96.0%, 75.8%, 33.3%, and 99.3% by combined HC2 and genotypes HPV16/18/52/58. Triage using combined HC2 and genotypes HPV16/18/52/58 showed significantly greater area under the receiver operating curve than the other 2 methods (P < 0.001). Combined HPV DNA testing and genotyping for HPV16/18/52/58 is useful for triaging women with minor cervical cytological abnormalities in northern Thailand.
Collapse
Affiliation(s)
- Surapan Khunamornpong
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jongkolnee Settakorn
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Kornkanok Sukpan
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jatupol Srisomboon
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Sumalee Siriaunkgul
- Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|