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Tsampazis N, Vavoulidis E, Margioula-Siarkou C, Symeonidou M, Intzes S, Papanikolaou A, Dinas K, Daniilidis A. The Diagnostic Accuracy of Electrical Impedance Spectroscopy-Assisted Colposcopy, HPV mRNA Test, and P16/Ki67 Immunostaining as CIN2+ Predictors in Greek Population. Diagnostics (Basel) 2024; 14:1379. [PMID: 39001269 PMCID: PMC11240963 DOI: 10.3390/diagnostics14131379] [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: 06/04/2024] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024] Open
Abstract
OBJECTIVE To evaluate the diagnostic accuracy of Electrical Impedance Spectroscopy (EIS)-assisted colposcopy in detecting CIN2+ Greek women towards standalone colposcopy, HPV mRNA testing, and p16/Ki67 immunostaining. METHODS We conducted a cross-sectional observational study at the Cervical Pathology Clinic of the 2nd Obstetrics-Gynecology University Department of Hippokration Hospital Thessaloniki involving 316 patients from January 2022 to August 2023. All participants provided liquid-based cervical samples for cytology, HPV mRNA testing, and p16/Ki67 immunostaining. MAIN OUTCOME MEASURES Subsequently, participants underwent both standalone colposcopy and EIS/ZedScan-assisted colposcopy, followed by cervical punch biopsies. RESULTS The incorporation of EIS significantly enhanced the sensitivity of colposcopy, increasing it from 54.17% to 100%, equivalent to that of HPV mRNA testing and p16/Ki67 immunostaining, while achieving a high specificity (95.45%). The specificities observed with EIS/ZedScan-assisted and standalone colposcopy were notably superior to those of HPV-related biomarkers (HPV mRNA test and p16/Ki67 immunostaining). When compared to standalone colposcopy, HPV mRNA testing, and p16/Ki67 immunostaining, EIS/ZedScan-assisted colposcopy demonstrated the most favorable combination of Positive and Negative Predictive Values, at 90.57% and 100%, respectively. The inclusion of EIS/ZedScan in colposcopy led to the detection of 44 additional cases of true CIN2+ (100% of the total CIN2+ confirmed histologically) that were missed by standalone colposcopy. This discovery suggests a 45.83% increase in the detection of CIN2+ cases. CONCLUSIONS The integration of EIS with colposcopy has demonstrated effectiveness in detecting cervical lesions, resulting in a significant detection increase of CIN2+ cases while offering optimal levels of sensitivity, specificity, and predictive values for CIN2+ detection.
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Affiliation(s)
- Nikolaos Tsampazis
- 2nd Department of Obstetrics & Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Hippokration General Hospital, 56429 Thessaloniki, Greece
| | - Eleftherios Vavoulidis
- 2nd Department of Obstetrics & Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Hippokration General Hospital, 56429 Thessaloniki, Greece
| | - Chrysoula Margioula-Siarkou
- 2nd Department of Obstetrics & Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Hippokration General Hospital, 56429 Thessaloniki, Greece
| | - Marianthi Symeonidou
- 2nd Department of Obstetrics & Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Hippokration General Hospital, 56429 Thessaloniki, Greece
| | - Stergios Intzes
- 2nd Department of Obstetrics & Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Hippokration General Hospital, 56429 Thessaloniki, Greece
| | - Alexios Papanikolaou
- 2nd Department of Obstetrics & Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Hippokration General Hospital, 56429 Thessaloniki, Greece
| | - Konstantinos Dinas
- 2nd Department of Obstetrics & Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Hippokration General Hospital, 56429 Thessaloniki, Greece
| | - Angelos Daniilidis
- 1st Department of Obstetrics & Gynecology, Medical Faculty, Aristotle University of Thessaloniki, Papageorgiou General Hospital, 54124 Thessaloniki, Greece
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Tsige AW, Beyene DA. Cervical cancer: Challenges and prevention strategies: A narrative review. Health Sci Rep 2024; 7:e2149. [PMID: 38826620 PMCID: PMC11139676 DOI: 10.1002/hsr2.2149] [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: 02/03/2024] [Revised: 03/25/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024] Open
Abstract
Background and Aims Human papillomavirus (HPV) infections that continue to exist are the main cause of cervical cancer (CC), two-thirds of CC occurrences worldwide are caused by HPV 16 and HPV 18, and 99.7% of CC tumors are linked to oncogenic HPV infection. To identify challenges of CC and its prevention and treatment modalities. Methods This review examined the epidemiology, predisposing factors, genetic factors, clinical assessment methods, current treatment options, and prevention approaches for CC. We had perform a narrative data synthesis rather than a pooled analysis. A thorough literature search in pertinent databases related to CC was done with the inclusion of data that were published in the English language. Results Early detection of CC is of utmost importance to detect precancerous lesions at an early stage. Therefore, all responsible agencies concerned with health should make all women aware of the benefits of CC screening and educate the general public. HPV vaccination coverage is very low in resource-limited settings. Conclusion To achieve the goal of eliminating CC as a public health problem in 2030, the World Health Organization will pay special attention to increasing HPV vaccination coverage throughout the world. To further improve HPV vaccine acceptability among parents and their children, safety-related aspects of the HPV vaccine should be further investigated through post-marketing surveillance and multicentre randomized clinical trials.
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Affiliation(s)
- Abate Wondesen Tsige
- Department of Pharmacy, Asrat Woldeyes Health Science CampusDebre Berhan UniversityDebre BerhanEthiopia
| | - Dessale Abate Beyene
- Department of Pharmacy, Asrat Woldeyes Health Science CampusDebre Berhan UniversityDebre BerhanEthiopia
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Yao B, Peng J, Song W, Yang L, Zhang M, Wu X, Wu S, Wang X, Li C, Yang C. Real-world effectiveness of cytology and HPV-based screening strategy in cervical cancer screening: A cross-sectional population-based study in Chengdu, China. PLoS One 2024; 19:e0299651. [PMID: 38422039 PMCID: PMC10903839 DOI: 10.1371/journal.pone.0299651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
Cervical cancer poses a significant health challenge in developing countries, emphasizing the need for appropriate screening strategies to accelerate the elimination of this disease. This study summarized the results of a large-scale community-based cervical cancer screening program conducted in Chengdu, China, to understand the prevalence of HPV infection and cervical lesions in the population, and to compare the real-world effectiveness of two different screening methods implemented in the program. From January 2021 to December 2022, a total of 363,376 women aged 35-64 years in Chengdu received free screenings. Among these participants, 70.1% received cytology screening and 29.9% received HPV testing combined with 16/18 genotyping and cytology triage. Ultimately, 824 cases of high-grade lesions and cervical cancer were detected, with a total detection rate of cervical cancer and precancerous lesions of 226.8 per 100,000. The follow-up rate of patients with high-grade lesions and above was 98.9%, and the treatment rate was 86.6%. The overall high-risk HPV infection rate was 11.7%, with the HPV 16/18 infection rate of 1.4%. The rate of abnormal cytology results was 2.8%. The attendance rates for colposcopy and histopathology were 71.6% and 86.1%, respectively. By calculating the age-standardized rates to eliminate the different age composition between the two group, the HPV-based screening strategy had a higher rate of primary screening abnormalities (3.4% vs. 2.8%, P<0.001), higher attendance rates of colposcopy (76.5% vs. 68.9%, P<0.001) and histopathological diagnosis (94.1% vs. 78.0%, P<0.001), higher percentage of abnormal colposcopy results (76.0% vs. 44.0%, P<0.001), and higher detection rate of cervical precancerous lesions and cancer (393.1 per 100,000 vs. 156.4 per 100,000, P<0.001) compared to cytology screening. Our study indicates that the combination of HPV testing with 16/18 genotyping and cytology triage has demonstrated superior performance in cervical cancer screening compared to cytology alone in large-scale population.
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Affiliation(s)
- Boshuang Yao
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Non-communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Jieru Peng
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Non-communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Wei Song
- Chengdu Municipal Health Commission, Chengdu, Sichuan Province, China
| | - Liu Yang
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Meng Zhang
- Chengdu Municipal Health Commission, Chengdu, Sichuan Province, China
| | - Xia Wu
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Shiyi Wu
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Non-communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Xiaoyu Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Non-communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Chunrong Li
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
| | - Chunxia Yang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan Province, China
- Non-communicable Diseases Research Center, West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan Province, China
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Zamurovic M, Tomic A, Pikula A, Simanic S, Knezevic A, Jankovic M, Lackovic M, Djakovic E, Rovcanin M. Understanding the Dynamics of Human Papillomavirus and Diagnostic Discrepancies in Cervical Pathology: A Single Center Experience. Diagnostics (Basel) 2023; 13:3614. [PMID: 38132198 PMCID: PMC10743259 DOI: 10.3390/diagnostics13243614] [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: 10/27/2023] [Revised: 11/16/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Cervical cancer (CC) is the most prevalent gynecological malignancy and a leading cause of death among women. It is primarily caused by human papillomavirus (HPV) infection, with 99.7% of cases showing high-risk HPV genotypes. This study sheds light on HPV dynamics as well as the discrepancies of different CC screening modalities results while highlighting factors that may have contributed to such a scenario. Moreover, we underscore the importance of the non-viral etiology of CC as well. We examined the current trends of HPV infection and its effects on cervical health in women treated at a tertiary care center in Belgrade, Serbia. Patients with abnormal colposcopy findings like dysplasia and re-epithelization were more likely to test negative for HPV (p < 0.001). Interestingly, women with a positive Pap smear tested HPV negative significantly more often (p = 0.041). Finally, HPV-positive individuals were more likely to have CIN I and II histologies (p < 0.001), while CIN III occurred equally in women with and without the virus. It may be inferred that inconsistencies in detecting HPV and the presence of cervical lesions may eventually result in adjustments to screening guidelines, as is crucial to adopt a meticulous approach to promote periodical CC screening, as initial samples may test negative for HPV.
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Affiliation(s)
- Milena Zamurovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Ana Tomic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Aleksandra Pikula
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Sara Simanic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Aleksandra Knezevic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
- Institute of Microbiology and Immunology, Department of Virology, Faculty of Medicine, University of Belgrade, Dr Subotića Starijeg Street, 11000 Belgrade, Serbia
| | - Marko Jankovic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
- Institute of Microbiology and Immunology, Department of Virology, Faculty of Medicine, University of Belgrade, Dr Subotića Starijeg Street, 11000 Belgrade, Serbia
| | - Milan Lackovic
- Clinical Hospital Center, Dr Dragiša Mišović, Heroja Milana Tepica 1, 11000 Belgrade, Serbia
| | - Elena Djakovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
| | - Marija Rovcanin
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
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