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Yang C, Chang T, Chou H, Chao A, Hsu S, Shih Y, Huang H, Lin C, Chen M, Sun L, Huang K, Wu K, Hsieh W, Huang Y, Chen L, Lu C, Lin H, Cheng C. Evaluation of a novel vaginal cells self-sampling device for human papillomavirus testing in cervical cancer screening: A clinical trial assessing reliability and acceptability. Bioeng Transl Med 2024; 9:e10653. [PMID: 39036090 PMCID: PMC11256128 DOI: 10.1002/btm2.10653] [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: 11/07/2023] [Revised: 01/09/2024] [Accepted: 01/29/2024] [Indexed: 07/23/2024] Open
Abstract
Cervical cancer is a significant public health concern, particularly in low- and middle-income countries where resources for prevention and treatment are limited. Routine screening, such as the Papanicolaou test (Pap smears) and human papillomavirus (HPV) testing, plays a crucial role in the early detection and prevention of cervical cancer. However, the participation rate in cervical cancer screening programs remains below optimal levels due to various factors. This study aimed to evaluate the reliability and acceptability of the HygeiaTouch Self Sampling Kit for Women in collecting vaginal samples for HPV typing, comparing the results with samples collected by physicians. The study included 1210 women aged 21-65 from three medical centers in Taiwan. The findings indicated that the self-sampling kit was as effective as physician-collected specimens in terms of obtaining valid samples and identifying HPV. The agreement between the two methods was 88%, with a κ value of 0.75. Furthermore, the study assessed the mechanical characteristics of the self-sampling applicator through tensile, bending, and torque tests, and determined that it was safe for intravaginal use. Additionally, the study evaluated the safety and satisfaction of self-sampling and found a low rate of adverse events (0.7%) and high levels of satisfaction (over 90%) among participants. Overall, we demonstrated that the HygeiaTouch Self Sampling Kit for Women is a reliable and acceptable device for HPV testing and cervical screening, providing a convenient, safe, and effective alternative for women.
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Affiliation(s)
| | - Ting‐Chang Chang
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Hung‐Hsueh Chou
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial HospitalTaoyuanTaiwan
- School of Medicine, National Tsing Hua UniversityHsinchuTaiwan
| | - Angel Chao
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Shih‐Tien Hsu
- Department of Gynecology and ObstetricsTaichung Veterans General HospitalTaichungTaiwan
| | - Yu‐Hsiang Shih
- Department of Gynecology and ObstetricsTaichung Veterans General HospitalTaichungTaiwan
| | - Huei‐Jean Huang
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Cheng‐Tao Lin
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Min‐Yu Chen
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Lou Sun
- Department of Gynecology and ObstetricsTaichung Veterans General HospitalTaichungTaiwan
| | - Kuan‐Gen Huang
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
- Gynecologic Cancer Research Center, Chang Gung Memorial HospitalTaoyuanTaiwan
| | - Kai‐Yun Wu
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
| | - Wu‐Chiao Hsieh
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
| | - Yi‐Ting Huang
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
| | - Liang‐Hsuan Chen
- Division of Gynecologic Oncology, Department of Obstetrics and GynecologyChang Gung Memorial Hospital, Linkou BranchTaoyuanTaiwan
| | - Chien‐Hsing Lu
- Department of Gynecology and ObstetricsTaichung Veterans General HospitalTaichungTaiwan
| | - Hao Lin
- Department of Obstetrics and GynecologyKaohsiung Chang Gung Memorial HospitalKaohsiungTaiwan
| | - Chao‐Min Cheng
- Institute of Biomedical Engineering, National Tsing Hua UniversityHsinchuTaiwan
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Torres-Rojas FI, Mendoza-Catalán MA, Alarcón-Romero LDC, Parra-Rojas I, Paredes-Solís S, Leyva-Vázquez MA, Cortes-Arciniega JE, Bracamontes-Benítez CJ, Illades-Aguiar B. HPV molecular detection from urine versus cervical samples: an alternative for HPV screening in indigenous populations. PeerJ 2021; 9:e11564. [PMID: 34178456 PMCID: PMC8214846 DOI: 10.7717/peerj.11564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/14/2021] [Indexed: 11/20/2022] Open
Abstract
Background Cervical cancer (CC) is the fourth leading cause of death from neoplasms in women and is caused by the human papilloma virus (HPV). Several methods have been developed for the screening of cervical lesions and HPV; however, some socio-cultural factors prevent women from undergoing gynecological inspection, which results in a higher risk of mortality from cervical cancer in certain population groups as indigenous communities. This study aimed to compare the concordance in HPV detection from urine and cervical samples, to propose an alternative to cervical scraping, which is commonly used in the cervical cancer screening. Methodology The DNA from cervical scrapings and urine samples was extracted using the proteinase K method followed by precipitation with alcohol, phenol andchloroform; a modification of the proteinase K method was developed in the management of urine sediment. Viral genotyping was performed using INNOLipa. Results The study population consisted of 108 patients from an indigenous population at southern Mexico, 32 without squamous intraepithelial lesions (NSIL) and 76 with low squamous intraepithelial lesions (LSIL). The majority of NSIL cervical scrapes were negative for HPV (90.63%), whereas more than half of LSIL cases were high-risk HPV positive (51.32%), followed by multiple infection by HR-HPV (17.11%), and multiple infection by LR- and HR-HPV (9.21%). No statistically significant relationship between the cytological diagnosis and the HPV genotypes detected in the urine samples was observed. A concordance of 68.27% for HPV positivity from urine and cervical samples was observed. Similarly, a concordance of 64.52% was observed in the grouping of HPVs by oncogenic risk. HR-HPV was detected in 71% of the urine samples from women with LSIL diagnosis, which suggests that HR-HPV detected in a urine sample could indicate the presence or risk of developing SIL. Conclusion HR-HPV detection in urine samples could be an initial approach for women at risk of developing LSIL and who, for cultural reasons, refuse to undergo a gynecological inspection.
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Affiliation(s)
- Francisco I Torres-Rojas
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Miguel A Mendoza-Catalán
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Luz Del C Alarcón-Romero
- Laboratorio de Citopatología e Histoquímica. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Isela Parra-Rojas
- Laboratorio de Investigación en Obesidad y Diabetes, Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México
| | - Sergio Paredes-Solís
- Centro de Investigación de Enfermedades Tropicales, Universidad Autónoma de Guerrero, Acapulco, Guerrero, México
| | - Marco A Leyva-Vázquez
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Jair E Cortes-Arciniega
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Carlos J Bracamontes-Benítez
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
| | - Berenice Illades-Aguiar
- Laboratorio de Biomedicina Molecular. Facultad de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo de los Bravo, Guerrero, Mexico
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Xu H, Yu Y, George W, Smith JS, Hu S, Dang L, Zhang X, Pan Q, Qiao Y, Zhao F. Comparison of the performance of paired urine and cervical samples for cervical cancer screening in screening population. J Med Virol 2019; 92:234-240. [DOI: 10.1002/jmv.25597] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/19/2019] [Indexed: 02/03/2023]
Affiliation(s)
- Huifang Xu
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Yanqin Yu
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Whitney George
- Department of HistoryUniversity of Chicago CollegeChicago Illinois
| | - Jennifer S. Smith
- Department of EpidemiologyUNC Gillings School of Global Public HealthChapel Hill North Carolina
- Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel Hill North Carolina
| | - Shangying Hu
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Le Dang
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Xun Zhang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Qinjing Pan
- Department of Cytopathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Youlin Qiao
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
| | - Fanghui Zhao
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing China
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Sabeena S, Kuriakose S, Binesh D, Abdulmajeed J, Dsouza G, Ramachandran A, Vijaykumar B, Aswathyraj S, Devadiga S, Ravishankar N, Arunkumar G. The Utility of Urine-Based Sampling for Cervical Cancer Screening in Low-Resource Settings. Asian Pac J Cancer Prev 2019; 20:2409-2413. [PMID: 31450914 PMCID: PMC6852825 DOI: 10.31557/apjcp.2019.20.8.2409] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 08/11/2019] [Indexed: 11/25/2022] Open
Abstract
Background: WHO has recommended Visual Inspection with Acetic acid (VIA) or Human Papillomavirus (HPV) DNA testing if feasible, for cervical cancer screening in low income countries. However, the number of women undergoing screening is very low as a result of limited information, inadequate infrastructure and invasive nature of sampling. Methods: A cross sectional study was carried out comparing HPV DNA detection by Polymerase Chain Reaction (PCR) in paired cervical and urine samples procured from histologically confirmed cervical cancer cases. Results: Amongst the samples collected from 114 cervical cancer cases, HPV DNA was tested positive in cervical samples of 89 (78.1%) and urine samples of 55 (48.2%) patients. The agreement between the two sampling methods was 66.7% and the kappa value was 0.35 indicating a fair agreement. The sensitivity of HPV detection using urine samples was 59.6% (95% confidence interval 49.16%-69.15%) and the specificity was 92% (95% confidence interval 75.0%-97.8%). Conclusion: Even though not acceptable as an HPV DNA screening tool due to low sensitivity, the urine sampling method is inexpensive and more socially acceptable for large epidemiological surveys in developing countries to estimate the burden.
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Affiliation(s)
- Sasidharanpillai Sabeena
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Santhosh Kuriakose
- Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
| | - Damodaran Binesh
- Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
| | - Jazeel Abdulmajeed
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Giselle Dsouza
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Amrutha Ramachandran
- Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Government Medical College, Kozhikode, Kerala, India
| | - Bindu Vijaykumar
- Department of Radiation Oncology, Government Medical College, Kozhikode, Kerala, India
| | - Sushama Aswathyraj
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Santhosha Devadiga
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
| | - Nagaraja Ravishankar
- Department of Statistics, Prasanna School of Public health, Manipal Academy of Higher Education, Karnatka, India
| | - Govindakarnavar Arunkumar
- Manipal Institute of Virology, Manipal Academy of Higher Education (Deemed to be University), Manipal, Karnataka, India.
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Maged AM, Saad H, Salah E, Meshaal H, AbdElbar M, Omran E, Eldaly A. Urine test for HPV genotypes as a predictor of precancerous cervical lesions and for cervical cancer screening. Int J Gynaecol Obstet 2018; 141:332-336. [PMID: 29383718 DOI: 10.1002/ijgo.12453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/06/2017] [Accepted: 01/26/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the sensitivity of a urine test for high-risk HPV DNA genotypes in the detection of high-grade squamous intra-epithelial lesion (HSIL) and its correlation with pathologic precancerous lesions. METHODS The present prospective cross-sectional study included women referred to Kasr AlAiny Medical School, Cairo, Egypt, for cervical smear anomalies, a history of cervical smear anomalies, or for suspicious cervix between May 1, 2015, and April 30, 2017. Paired urine tests and cervical smears were performed. HPV DNA was detected in urine using polymerase chain reaction and cervical smears were performed with a cervical spatula and a cytobrush. Agreement between urine test results and pathology was examined. RESULTS In total, 1375 women were included. Urine test for high-risk HPV DNA demonstrated 97.8% (95% confidence interval [CI] 92.1%-99.7%) sensitivity and 100% (95% CI 99.7%-100.0%) specificity for HSIL. Overall, 87 women had a positive urine test for high-risk HPV; of these, 82 (94.3%, 95% CI 87.1%-98.1%) had pathologic findings of cervical intra-epithelial neoplasia 2 or 3 (CIN2/3). Similarly, 89 women had HSIL cytology; again, 82 had CIN2/3 (92.1%; 95% CI, 84.3%-96.4%). CONCLUSION There was good agreement between a positive urine test for high-risk HPV DNA genotypes and pathologic findings of CIN2/3.
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Affiliation(s)
- Ahmed M Maged
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Hany Saad
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Emad Salah
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Hadeer Meshaal
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Mostafa AbdElbar
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Eman Omran
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
| | - Ashraf Eldaly
- Obstetrics and Gynecology Department, Cairo University, Giza Governorate, Egypt
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Lee H, Choi M, Hwang SH, Cho Y. A Versatile Nanowire Platform for Highly Efficient Isolation and Direct PCR-free Colorimetric Detection of Human Papillomavirus DNA from Unprocessed Urine. Am J Cancer Res 2018; 8:399-409. [PMID: 29290816 PMCID: PMC5743556 DOI: 10.7150/thno.21696] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 08/09/2017] [Indexed: 11/05/2022] Open
Abstract
Purpose: As human papillomavirus (HPV) is primarily responsible for the development of cervical cancer, significant efforts have been devoted to develop novel strategies for detecting and identifying HPV DNA in urine. The analysis of target DNA sequences in urine offers a potential alternative to conventional methods as a non-invasive clinical screening and diagnostic assessment tool for the detection of HPV. However, the lack of efficient approaches to isolate and directly detect HPV DNA in urine has restricted its potential clinical use. In this study, we demonstrated a novel approach of using polyethylenimine-conjugated magnetic polypyrrole nanowires (PEI-mPpy NWs) for the extraction, identification, and PCR-free colorimetric detection of high-risk strains of HPV DNA sequences, particularly HPV-16 and HPV-18, in urine specimens of cervical cancer patients. Materials and Methods: We fabricated and characterized polyethylenimine-conjugated magnetic nanowires (PEI/mPpy NWs). PEI/mPpy NWs-based HPV DNA isolation and detection strategy appears to be a cost-effective and practical technology with greater sensitivity and accuracy than other urine-based methods. Results: The analytical and clinical performance of PEI-mPpy NWs was evaluated and compared with those of cervical swabs, demonstrating a superior type-specific concordance rate of 100% between urine and cervical swabs, even when using a small volume of urine (300 µL). Conclusion: We envision that PEI-mPpy NWs provide substantive evidence for clinical diagnosis and management of HPV-associated disease with their excellent performance in the recovery and detection of HPV DNA from minimal amounts of urine samples.
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Comparison of Human Papillomavirus Detection in Urine and Cervical Samples Using High-Risk HPV DNA Testing in Northern Thailand. Obstet Gynecol Int 2016; 2016:6801491. [PMID: 28101107 PMCID: PMC5215104 DOI: 10.1155/2016/6801491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/15/2016] [Accepted: 11/30/2016] [Indexed: 11/22/2022] Open
Abstract
Objective. To evaluate the performance of high-risk human papillomavirus (HPV) DNA testing in urine samples compared to that of cervical sample testing in Northern Thailand. Methods. Paired urine and cervical samples were collected during the follow-up of women with a previous positive HPV test. HPV testing was performed using the Cobas 4800 HPV Test. Linear Array assay was used for genotyping in selected cases. Results. Paired urine and cervical samples were obtained from 168 women. Of 123 paired samples with valid results, agreement in the detection of high-risk HPV DNA was present in 106 cases (86.2%), with a kappa statistic of 0.65 (substantial agreement). Using the cervical HPV results as a reference, the sensitivity of urine HPV testing was 68.6% (24/35) and the specificity 93.2% (82/88). For the detection of histologic high-grade squamous intraepithelial lesion or worse (HSIL+), the sensitivity of urine HPV testing was 80.0% (4/5) and the specificity 78.0% (92/118). Conclusion. Although urine HPV testing had a rather low sensitivity for HPV detection, its sensitivity for histologic HSIL+ detection was high. For clinical use of urine HPV testing, standardization of specimen collection and processing techniques or application of a more sensitive test, especially in the detection of HPV52 and HPV58, is necessary.
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