1
|
Guo M, Shlyakhova N, Khanna A, Tinnirello AA, Schmeler KM, Hwang J, Sturgis EM, Stewart J. Validation of cobas 4800 HPV assay in SurePath Papanicolaou specimens for cervical cancer screening. J Am Soc Cytopathol 2021; 10:399-405. [PMID: 33967024 DOI: 10.1016/j.jasc.2021.04.002] [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: 03/09/2021] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The cobas (Roche Diagnostics, Indianapolis, IN) HPV assay was approved by the US Food and Drug Administration for human papillomavirus (HPV) testing in SurePath (Becton Dickinson, Franklin Lakes, NJ) Papanicolaou specimens for cervical cancer prevention. To validate the cobas HPV assay in SurePath specimens in our institution, we compared its accuracy and clinical efficacy to that of the Cervista (Hologic, Marlborough, MA) HPV HR assay. METHODS This study used 138 Papanicolaou (Pap) cytology specimens collected in SurePath preservative fluid at our institution in 2018. After Pap cytology testing, the residual specimens were split for testing with the cobas and Cervista assays. Polymerase chain reaction (PCR)-based HPV testing (GP5+/GP6+) was performed on specimens with discrepant results. Clinical follow-up data were reviewed. RESULTS The cobas HPV and Cervista HPV HR assays showed good concordance (89.1%), with a kappa value of 0.78 (95% CI: 0.675-0.885). Fifteen specimens showed discrepant results between the 2 assays. Of 7 cases with cobas+/Cervista- results, 5 (71%) were confirmed positive by PCR. Of 8 cases with cobas-/Cervista+ results, 4 (50%) were confirmed positive by PCR. cobas HPV and Cervista HPV HR showed the same HPV-positive rate in cases of pathologically diagnosed ASC-H, LSIL, or HSIL. The sensitivities and specificities for detecting high-risk HPV of cobas HPV (93.7%, 97.3%) and Cervista HPV HR (92.1%, 94.7%) were comparable. The cobas HPV assay had false-negative results in 4 cases (5.2%) including 1 false-negative case that failed to predict CIN3. CONCLUSIONS The cobas HPV assay is valid in SurePath Pap cytology specimens for cervical cancer screening but has limitations of false-negative results with clinical implications.
Collapse
Affiliation(s)
- Ming Guo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Natalya Shlyakhova
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Abha Khanna
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Agata A Tinnirello
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kathleen M Schmeler
- Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jessica Hwang
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M Sturgis
- Department of Head and Neck Surgery The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas
| | - John Stewart
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
2
|
Loonen AJM, Huijsmans CJJ, Geurts-Giele WRR, Leeijen C, van der Linden JC, van den Brule AJC. Performance analysis of high-throughput HPV testing on three automated workflows. APMIS 2020; 128:497-505. [PMID: 32562292 DOI: 10.1111/apm.13064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 06/02/2020] [Indexed: 12/29/2022]
Abstract
Primary high-risk human papillomavirus (hrHPV) DNA testing has been introduced in several countries worldwide, including The Netherlands. The objective of this study was to compare three automated workflow procedures for hrHPV testing of which the hrHPV detection assays meet the international guidelines for HPV testing. To mimic a realistic screening situation, we aimed to process 15 000 residual PreservCyt cervical samples in a period of 3 months. During a 3 months period, four technicians were involved in processing 5000 specimens per month on three automated platforms, (1) Qiagen Digene® HC2 HPV DNA test (HC2, signal amplification); (2) Roche Cobas® HPV test (DNA amplification), and (3) Hologic Aptima® HPV test (RNA amplification). We measured and scored general aspects (time-to-results, hands-on-time (HOT)), maintenance, pre-run, run and post-run aspects, inventory (orders, storage), and number of errors on a scale from 1 to 10. As determined for one complete workflow each, maximum processing capacity and HOT were 296 samples and 2 h:55 m, 282 samples and 3 h:20 m, and 264 samples and 4 h:15 m for Aptima, Cobas, and HC2, respectively. The mean throughput time per run was 5 h:51 m for Cobas in which 94 samples could be processed. For Aptima, the mean throughput time per run was 6 h:30 m for 60 samples. Mean throughput time for HC2 is longer since results were provided on day 2. In this study, the fully automated Aptima workflow scores best with a 7.2, followed by Cobas with a score of 7.1 and HC2 with a score of 5.8. Although all HPV tests used in this comparison meet the international test guidelines, the performance (workflow) characteristics of the assays vary widely. A specific choice of a laboratory for high-throughput testing can be different based on the laboratory's demands, but also hands-on-time, time-to-results/ # samples, maintenance, pre-run, run and post-run parameters, consumables, technical support, and number of errors are important operational factors for the selection of a fully automated workflow for hrHPV testing.
Collapse
Affiliation(s)
- Anne J M Loonen
- Pathologie-DNA, Lab for Molecular Diagnostics, Location Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.,Department of Applied Natural Sciences, Section Diagnostics and Test Development, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Cornelis J J Huijsmans
- Pathologie-DNA, Lab for Molecular Diagnostics, Location Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | - Cindy Leeijen
- Pathologie-DNA, Lab for Molecular Diagnostics, Location Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Johannes C van der Linden
- Pathologie-DNA, Lab for Molecular Diagnostics, Location Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - Adriaan J C van den Brule
- Pathologie-DNA, Lab for Molecular Diagnostics, Location Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| |
Collapse
|
3
|
Lewitowicz P, Nasierowska-Guttmejer A, Rokita W, Adamczyk-Gruszka O, Gluszek S, Chrapek M, Kolos M, Wrona-Cyranowska A, Misiek M. HPV genotyping and p16/Ki-67 test significantly improve detection rate of high-grade cervical squamous intraepithelial lesion. Arch Med Sci 2020; 16:87-93. [PMID: 32051710 PMCID: PMC6963143 DOI: 10.5114/aoms.2018.80697] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 11/09/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Liquid-based cytology allows to apply modern and specific analyses of hrHPV genotyping in p16/Ki-67 test. All of these together could raise accuracy ratio for high-grade squamous intraepithelial lesion above 90%. The purpose of this study was to evaluate the diagnostic accuracy of LBC, hrHPV testing, and p16/Ki-67 testing in diagnosis of high-grade cervical intraepithelial lesions. MATERIAL AND METHODS The study consisted of 176 women, out of which 50 presented with HSIL (CIN2) SCC (cervical intraepithelial lesion grade 2 squamous cell carcinoma). 126 women with a negative Pap test were pooled into the second group of the study. All patients were resampled for LBC, HPV genotyping, and for the p16/Ki-67 test. The research was carried out between May and December 2017, and second sampling were taken from 1 to 4 months. RESULTS We reported a strong correlation between positive Pap test and hrHPV (p < 0.05) that met accuracy close to 90%. We noted correlations between a positive p16/Ki-67 with a positive Pap test: p < 0.001; 66% sensitivity (95% CI: 51.2-78.8%), 87.8% specificity (95% CI: 75.2-95.4%), 76.8% accuracy (95% CI: 67.2-84.7%), and OR 13.9 (95% CI: 4.9-39.2), especially HSIL and HPV16: p < 0.001; sensitivity (95% CI) 64.0, specificity (95% CI) 98.4, accuracy (95% CI) 88.6, OR (95% CI) 109.3. CONCLUSIONS The results of our study indicate hrHPV genotyping as a good biomarker for the triage of patients with an abnormal cytological report. In our opinion, the hrHPV test reaches the highest level of sensitivity, specificity, and accuracy, and should be considered as crucial diagnostic test in cervical screening.
Collapse
Affiliation(s)
- Piotr Lewitowicz
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Anna Nasierowska-Guttmejer
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Wojciech Rokita
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
- Department of Obstetrics and Gynecology Province Hospital, Kielce, Poland
| | - Olga Adamczyk-Gruszka
- Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
- Department of Obstetrics and Gynecology Province Hospital, Kielce, Poland
| | - Stanisław Gluszek
- Department of Surgery and Surgical Nursing, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | - Magdalena Chrapek
- Department of Probability Theory and Statistics, Institute of Mathematics, the Faculty of Mathematics and Natural Sciences, Jan Kochanowski University, Kielce, Poland
| | - Małgorzata Kolos
- Department of Pathology, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
| | | | - Marcin Misiek
- Clinic of Gynecology, Holy-Cross Oncology Centre, Kielce, Poland
| |
Collapse
|
4
|
Rebolj M, Njor S, Lynge E, Preisler S, Ejegod D, Rygaard C, Bonde J. Referral population studies underestimate differences between human papillomavirus assays in primary cervical screening. Cytopathology 2018; 28:419-428. [PMID: 28901682 DOI: 10.1111/cyt.12451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We studied how representative cytologically abnormal women ("referral populations") are with respect to uncovering differences between human papillomavirus (HPV) assays in the primary screening where most women are cytologically normal. METHODS A total of 4997 women were tested with SurePath® cytology, and Hybrid Capture 2 (HC2), cobas, CLART and APTIMA HPV assays. Women with positive test results were offered a follow-up. For all detected HPV infections and HPV-positive high-grade cervical intraepithelial neoplasia (≥CIN2), we studied the distributions of assay-specific signal strengths in the baseline samples as documented by the assays' automatically generated reports. We calculated the likelihood of test result discordance as the proportion of HPV-positive samples that were not confirmed by all four assays. RESULTS Median signal strengths for HPV infections were weaker in normal than abnormal cytology (P<.001, adjusted for women's age, multiple infections and the reason for taking the sample). For HC2, they were RLU/CO 11.0 (interquartile range, IQR: 3.3-52.8) vs 124.2 (IQR: 22.8-506.9), respectively; for cobas, Ct 33.5 (IQR: 29.6-37.5) vs 26.9 (IQR: 23.7-31.3), respectively; for APTIMA, S/CO 10.2 (IQR: 5.8-11.3) vs 11.1 (IQR: 9.4-15.5), respectively. Similar patterns were observed for HPV-positive ≥CIN2. The four HPV assays more frequently returned discordant test results in normal than in abnormal cytology. Relative frequency of discordance in detecting HPV infections was 0.39 (95% confidence interval: 0.33-0.48) for abnormal vs normal cytology. CONCLUSIONS These data suggest that referral population studies, by not including sufficient numbers of cytology normal women, underestimate the differences between HPV assays that would become apparent in primary screening.
Collapse
Affiliation(s)
- M Rebolj
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - S Njor
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - E Lynge
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - S Preisler
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - D Ejegod
- Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - C Rygaard
- Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - J Bonde
- Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| |
Collapse
|
5
|
Fuller MY, Mody RR, Luna E, Armylagos D, Schwartz MR, Mody DR, Ge Y. Performance of Roche cobas high-risk human papillomavirus (hrHPV) testing in the two most common liquid-based Papanicolaou test platforms. J Am Soc Cytopathol 2018; 7:142-148. [PMID: 31043309 DOI: 10.1016/j.jasc.2017.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/28/2017] [Accepted: 10/05/2017] [Indexed: 06/09/2023]
Abstract
INTRODUCTION High-risk human papillomavirus (hrHPV) testing is important in cervical cancer screening and management algorithms. Roche (Pleasanton, Calif.) cobas hrHPV testing is commonly performed on both ThinPrep (TP) and SurePath (SP) samples, but performance of these platforms has not been fully investigated in the literature. MATERIALS AND METHODS Roche hrHPV testing was performed on 47,885 (TP = 18,295; SP = 29,590) out of 130,648 consecutive Papanicolaou tests, over 16 months; 1895 of those had interpretable biopsies. RESULTS The overall hrHPV detection rates were similar in TP (13.5%) and SP (13.1%). The hrHPV positive rate was higher in SP (8.5%) than TP (7.3%, P < 0.0001) in women with negative cytology; the difference in other cytologic diagnosis categories was insignificant. TP samples had significantly fewer negative cytology diagnoses (7.3% versus 8.5%, P < 0.0001), more low-grade abnormalities in cytology and biopsies, and higher colposcopy referral rate (4.8% versus 2.7%, P < 0.0001) than SP. There were no differences between TP and SP in detecting ≥HSIL by hrHPV testing, cytology or biopsy. SP samples had a significantly higher rate of HPV 16/18 but a lower rate of non-16/18 hrHPV genotypes than TP. CONCLUSIONS Roche cobas hrHPV testing was similar in both TP and SP platforms. The significantly lower hrHPV detection rate in cytological negative TP samples is likely related to higher cytology reporting rates for indeterminate and low-grade diagnoses in TP than SP samples. Significant differences were also observed in hrHPV genotyping results between TP and SP. Clinical risk stratification based on hrHPV testing may need to take testing platforms into consideration.
Collapse
Affiliation(s)
- Maren Y Fuller
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | | | - Eric Luna
- BioReference Laboratories, Houston, Texas
| | | | - Mary R Schwartz
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Dina R Mody
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Weill Medical College of Cornell University, New York, New York
| | - Yimin Ge
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Weill Medical College of Cornell University, New York, New York.
| |
Collapse
|
6
|
Bottari F, Boveri S, Iacobone AD, Gulmini C, Igidbashian S, Cassatella MC, Landoni F, Sandri MT. Transition from Hybrid Capture 2 to Cobas 4800 in Hpv detection: sensitivity and specificity for Cin2+ in two time periods. Infect Dis (Lond) 2018; 50:554-559. [DOI: 10.1080/23744235.2018.1441538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Fabio Bottari
- Division of Laboratory Medicine, European Institute of Oncology, Milan, Italy
| | - Sara Boveri
- Preventive Gynecology Unit, European Institute of Oncology, Milan, Italy
| | | | - Chiara Gulmini
- Division of Laboratory Medicine, European Institute of Oncology, Milan, Italy
| | - Sarah Igidbashian
- Preventive Gynecology Unit, European Institute of Oncology, Milan, Italy
| | | | - Fabio Landoni
- Preventive Gynecology Unit, European Institute of Oncology, Milan, Italy
| | - Maria Teresa Sandri
- Division of Laboratory Medicine, European Institute of Oncology, Milan, Italy
| |
Collapse
|
7
|
Huijsmans CJJ, Geurts-Giele WRR, Leeijen C, Hazenberg HLCM, van Beek J, de Wild C, van der Linden JC, van den Brule AJC. HPV Prevalence in the Dutch cervical cancer screening population (DuSC study): HPV testing using automated HC2, cobas and Aptima workflows. BMC Cancer 2016; 16:922. [PMID: 27894291 PMCID: PMC5127037 DOI: 10.1186/s12885-016-2961-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 11/22/2016] [Indexed: 12/21/2022] Open
Abstract
Background Primary high risk (hr)HPV screening will be introduced in The Netherlands in January 2017. Our aim was to determine the hrHPV prevalence in the Dutch cervical cancer screening population (DuSC study). Methods A total of 12,113 residual PreservCyt cervical samples from the Dutch population based cytology screening program were rendered anonymous, randomized and tested for hrHPV using 3 HPV assays on their respective automated platforms: QIAGEN’s digene® HC2 HPV DNA Test® (HC2, signal amplification), Roche Cobas® HPV test (DNA amplification) and Hologic Aptima® HPV Test (RNA amplification). To determine the agreement between results generated using the different assays, pair wise comparison of the systems was performed by determining kappa coefficients. Results The selected samples were representative for the population based screening program with respect to age distribution and cytology classification. HrHPV prevalences found were: 8.5% for HC2 (n = 959), 8.1% for cobas (n = 919) and 7.5% for Aptima (n = 849), resulting in a mean hrHPV prevalence of 8.0 ± 0.5%. Although the hrHPV prevalences of the different assays are in the range of 8%, there was a significant difference in prevalence for the HC2 vs. Aptima assay (p-value = 0.007). A clear age dependency was found, with an hrHPV prevalence ranging from 18.7 ± 1.2% in women 29-33 years of age to 4.2 ± 0.2% in women 59–63 years of age. Furthermore, a correlation between hrHPV prevalence and severity of cytology was observed, ranging from 5.5 ± 0.4% in normal cytology to 95.2 ± 1.7% in severe dysplasia. Indeed, kappa coefficients of 0.77, 0.71 and 0.72 (HC2 vs cobas, cobas vs Aptima and Aptima vs HC2, respectively) indicated substantial agreement between the results generated by the different systems. However, looking at the hrHPV positive samples, only 48% of the samples tested positive with all 3 assays. Conclusions A hrHPV prevalence of 8% was found in this unselected population based screening cohort independently of using HC2, Aptima or cobas. This prevalence is higher than the previously reported 4–5% (POBASCAM and VUSA-Screen trials). Furthermore, the complete automated hrHPV detection workflow solutions from QIAGEN, Roche, and Hologic were successfully used and will be valuable for reliably implementing high throughput hrHPV testing in cervical cancer screening.
Collapse
Affiliation(s)
| | - Willemina Rosalia Rita Geurts-Giele
- Pathologie-DNA, Location Jeroen Bosch Hospital, Henri-Dunantstraat 1, 5223 GZ, Den-Bosch, The Netherlands.,Department of Pathology, Erasmus MC Cancer Institute, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
| | - Cindy Leeijen
- Pathologie-DNA, Location Jeroen Bosch Hospital, Henri-Dunantstraat 1, 5223 GZ, Den-Bosch, The Netherlands
| | | | - Jenneke van Beek
- Pathologie-DNA, Location Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands
| | - Carola de Wild
- Pathologie-DNA, Location Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands
| | | | | |
Collapse
|