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Zhou F, Chen Y, Strickland AL, Chen H, Zhang X. Prevalence of genotype-specific human papillomavirus in cytology specimens and cervical biopsies, and its implication in cervical cancer risk stratification: a retrospective study of 10647 cases. J Cancer 2021; 12:7167-7176. [PMID: 34729118 PMCID: PMC8558667 DOI: 10.7150/jca.60601] [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: 03/18/2021] [Accepted: 10/07/2021] [Indexed: 11/08/2022] Open
Abstract
Objective: This study aimed to describe the risk stratification of squamous cell carcinoma (SCC) and its precursor lesions based on HPV E6/E7 mRNA genotyping. Methods: 10647 hrHPV+ women (mean age 40.8 years), who had concurrent cytology and follow-up biopsy results available between September 2016 and May 2020, met the inclusion criteria and were selected for immediate risk analysis. Results: In this cohort, HPV-16 or 18/45+ women had significantly higher immediate risk of cervical cancer and precancer compared with other genotypes+ women. The relative immediate risk (RIR) of ASC-H+ was 2.0 (95% CI: 1.9-2.4) and SCC was 9.4 (95% CI: 5.5-15.6) for HPV-16 or 18/45+ women when compared with women positive for other 11 genotypes. Among follow-up biopsy cases, the RIR of CIN2+ was 2.7 (95% CI: 3.0-3.7) and SCC was 10.8 (95% CI: 7.2-17.4) for HPV-16 or 18/45+ women than women positive for other genotypes. Similarly, when compared with women positive for other genotypes, the RIR of CIN2+ was 2.9 (95% CI: 2.7-4.6) and SCC was 13.8 (95% CI: 3.0-66.2) for HPV-16 or 18/45+ women with ASC-US, and RIR of CIN2+ was 3.3 (95% CI: 3.1-4.6) and SCC was 22.3 (95% CI: 2.8-176.8) for HPV-16 or 18/45+ women with NILM. Conclusions: This study supports that hrHPV mRNA genotyping can be an effective risk stratification tool to identify individual at higher risk for cervical cancer or precancer, and provides important evidences for the future modifications for current China cervical cancer screening guidelines.
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Affiliation(s)
- Feng Zhou
- Department of Pathology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang Province, 310006, China
| | - Yuezhou Chen
- Reproductive Medicine Center, Zhongshan City People's Hospital, Zhongshan, Guangdong Province, 528403, China
| | - Amanda Louise Strickland
- Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA
| | - Hao Chen
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Xiaofei Zhang
- Department of Pathology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang Province, 310006, China
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Carcea F, Vavoulidis E, Petousis S, Papandreou P, Siarkou CM, Nasioutziki M, Papanikolaou A, Dinas K, Daniilidis A. Diagnostic performance of HPV E6/E7 mRNA testing towards HPV-DNA testing and p16/Ki67 immunostaining as a biomarker of high-risk HPV recurrence in Greek women surgically treated for their cervical lesions. J Obstet Gynaecol Res 2021; 47:3607-3617. [PMID: 34374179 DOI: 10.1111/jog.14976] [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: 04/11/2021] [Revised: 07/11/2021] [Accepted: 07/29/2021] [Indexed: 11/26/2022]
Abstract
AIM To evaluate the diagnostic performance of E6/E7 HPV-mRNA overexpression towards HPV-DNA testing and p16/Ki67 immunocytochemistry in a post-op population to verify if this biomarker can be effectively used as indicator of successful cervical intraepithelial neoplasia (CIN) treatment. METHODS Our study retrospectively analyzed 197 patients of our Colposcopy Clinic between January 2013 and September 2020 coming with an abnormal Pap smear suggestive for colposcopy, and after a series of follow-ups including liquid-based cytology (LBC) and punch-biopsy sampling, there were surgically treated. LBC was used for cytology and molecular analysis of the three HPV-related biomarkers. RESULTS Six months after treatment, 93% of the HPV-mRNA-positive women became negative while this applied to only 80.2% of the HPV-DNA-positive women. HPV persistence was 6.9% at 6-12 months after treatment. The comparison among cytology, colposcopy, HPV-DNA test, and HPV-mRNA test after treatment revealed that the last one is the only with a strong correlation with actual severity (histology during treatment) (ρ = 0.345, p = 0.006) implying that clinical cases with more severe CIN may have higher chances of unsuccessful treatment. HPV-mRNA test had higher sensitivity (100%), specificity (96.88%), and positive predictive value (45.45%) for CIN2+ recurrent lesions when compared with HPV-DNA testing (80%, 82.81%, 10.81% respectively) and p16/Ki67 immunocytochemistry (80%, 95.83%, 33.33% respectively) while their negative predictive values were similar. CONCLUSIONS E6/E7 mRNA detection has higher diagnostic values for the prediction of treatment failure compared with HPV-DNA testing and p16/Ki67 immunocytochemistry, and as an outcome could be used as predictive indicator of CIN-treatment status.
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Affiliation(s)
- Fausto Carcea
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Eleftherios Vavoulidis
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Stamatios Petousis
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Panagiotis Papandreou
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Chrysoula Margioula Siarkou
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Maria Nasioutziki
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Alexios Papanikolaou
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Konstantinos Dinas
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
| | - Angelos Daniilidis
- 2nd Department of Obstetrics and Gynecology, Medical Faculty Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece
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Macedo ACL, Gonçalves JCN, Bavaresco DV, Grande AJ, Chiaramonte Silva N, Rosa MI. Accuracy of mRNA HPV Tests for Triage of Precursor Lesions and Cervical Cancer: A Systematic Review and Meta-Analysis. JOURNAL OF ONCOLOGY 2019; 2019:6935030. [PMID: 31281360 PMCID: PMC6594270 DOI: 10.1155/2019/6935030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 05/26/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This systematic review evaluates the accuracy of the mRNA HPV biomarker in cervical smears to identify cervical intraepithelial neoplasia (CIN) 2 or 3 and cervical cancer. DATA SOURCE Eligible studies were identified by performing a search of electronic databases on Medline via Pubmed, Lilacs, Cochrane Library, Embase, and Grey literature for papers published between January 1990 and June 2018. STUDY ELIGIBILITY CRITERIA As no randomized studies were identified, this review focuses on observational studies in which the mRNA HPV diagnostic test was compared to a histopathology reference standard. We analyzed studies that included women screened for cervical cancer using mRNA HPV. STUDY APPRAISAL AND SYNTHESIS METHODS After screening, 61 studies including 29,674 patients met the inclusion criteria and were analyzed. Dichotomization was performed by defining CIN2 or worse (CIN2+) versus CIN1, HPV infection, and normal (CIN 1-). The analysis was discriminated by the following tests: Aptima, PreTect HPV Profeer, NucliSens EasyQ HPV, OncoTect, and Quantivirus. RESULTS Analyzing by technique, Aptima, with 28 studies, exhibited superior performance, showing for the outcomes CIN2+ and CIN3+ an AUC of 0.88 (0.82-0.95) and 0.91 (0.84-0.99), a pooled sensitivity of 92.8% (95%CI 91.9-93.7) and 95.6% (95%CI 94.5-96.5), and a pooled specificity of 60.5% (95%CI 59.8-61.3) and 61.9% (95%CI 61.1-62.7), respectively. CONCLUSION This study supports the current hypothesis that the mRNA HPV assay is an adequate tool for secondary cervical cancer screening.
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Affiliation(s)
- Ana Cristina L. Macedo
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - João Carlos N. Gonçalves
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Daniela Vicente Bavaresco
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Antonio José Grande
- Laboratory of Evidence in Health, Medicine and Health Sciences, University of State of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Napoleão Chiaramonte Silva
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Maria Inês Rosa
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
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Macedo ACL, Borba CDLM, Bavaresco DV, Colonetti T, Grande AJ, Rosa MID. Accuracy of mRNA HPV tests as a predictor of recurrence of precursor lesions and cervical cancer after conization: a systematic review and meta-analysis. Biomark Med 2019; 13:497-506. [PMID: 30924676 DOI: 10.2217/bmm-2018-0373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Objective: This systematic review evaluates the accuracy of mRNA HPV biomarker for the identification of cervical intra-epithelial neoplasia (CIN) or cervical cancer during a follow-up after conization, taking histopathology as reference standard. Methods: A search of electronic databases was performed, for studies published until June 2018. As results, after screening, five studies including 1148 patients met the inclusion criteria. Dichotomization was performed by CIN2+ versus CIN1-. By analyzing all five studies, a sensitivity of 62.4% (95% CI: 54.8-69.7), specificity of 91.9% (95% CI: 90.0-93.5) and area under the curve of 0.5685 were revealed. Conclusion: mRNA HPV assay presents a high specificity and is an adequate tool for cervical cancer screening in the follow-up after conization.
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Affiliation(s)
- Ana Cristina L Macedo
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC 88806-000, Brazil
| | - Cristini da Luz Moretti Borba
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC 88806-000, Brazil
| | - Daniela Vicente Bavaresco
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC 88806-000, Brazil
| | - Tamy Colonetti
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC 88806-000, Brazil
| | - Antonio José Grande
- Laboratory of Evidence in Health, Medicine & Health Sciences, University of State of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Maria Inês da Rosa
- Translational Biomedicine Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC 88806-000, Brazil
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Analytic and Diagnostic Performances of Human Papillomavirus E6/E7 mRNA Test on up-to 11-Year-Old Liquid-Based Cervical Samples. A Biobank-Based Longitudinal Study. Int J Mol Sci 2017; 18:ijms18071480. [PMID: 28696386 PMCID: PMC5535970 DOI: 10.3390/ijms18071480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/02/2017] [Accepted: 07/02/2017] [Indexed: 01/14/2023] Open
Abstract
Human Papillomavirus (HPV) E6/E7 mRNA test demonstrated high specificity in detecting HPV infections, but studies assessing its efficacy in terms of cancer risk stratification are lacking. Follow-up studies are arduous and expensive. Biobank would be the answer to the problem, although data investigating the effects of long-term storage on RNA preservation are still needed. We addressed these issues by retrieving 202 residual liquid-based cervical specimens, collected from 149 women attending cervical cancer screening during the years 2001–2012. Samples were stored in Adriatic Biobank at room temperature and without any handing. After calculation of RNA yield and purity, E6/E7 mRNA test was retrospectively performed on each samples, to assess analytic and diagnostic performances. Using automated extraction procedures, RNA of good quantity and quality was obtained. The mean value of RNA concentration was 27.5 ng/μL. The mean A260/A280 ratio was 2.1. An invalid mRNA test result was found in 11.9% of the specimens. Neither RNA integrity, nor analytic performances of mRNA test were influenced by the year of sample collection. In total, 62.4% of the specimens tested as mRNA positive; among these, 89.2% were CIN2+. E6/E7 mRNA was detected in all Squamous Cervical Cancer (SCC) cases. Percentage of positive samples increased with the severity of histological diagnosis. mRNA testing, showing specificity and predictive values of 75.6% and 84.4%, respectively, significantly improved the corresponding values for DNA testing. Thus, the reflex mRNA test was demonstrated to be suitable to triage women with persistent cervical lesions. A “one sample for all” approach is possible, with practical benefits for Biobank-based long-term longitudinal studies, diseases prevention, prediction, diagnosis and treatment.
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Pedersen K, Burger EA, Sy S, Kristiansen IS, Kim JJ. Cost-effective management of women with minor cervical lesions: Revisiting the application of HPV DNA testing. Gynecol Oncol 2016; 143:326-333. [PMID: 27542966 DOI: 10.1016/j.ygyno.2016.08.231] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/03/2016] [Accepted: 08/04/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lack of consensus in management guidelines for women with minor cervical lesions, coupled with novel screening approaches, such as human papillomavirus (HPV) genotyping, necessitate revisiting prevention policies. We evaluated the cost-effectiveness and resource trade-offs of alternative triage strategies to inform cervical cancer prevention in Norway. METHODS We used a decision-analytic model to compare the lifetime health and economic consequences associated with ten novel candidate approaches to triage women with minor cervical lesions. Candidate strategies varied by: 1) the triage test(s): HPV testing in combination with cytology, HPV testing alone with or without genotyping for HPV-16 and -18, and immediate colposcopy, and 2) the length of time between index and triage testing (i.e., 6, 12 or 18months). Model outcomes included quality-adjusted life-years (QALYs), lifetime societal costs, and resource use (e.g., colposcopy referrals). RESULTS The current Norwegian guidelines were less effective and more costly than candidate strategies. Given a commonly-cited willingness-to-pay threshold in Norway of $100,000 per QALY gained, the preferred strategy involved HPV genotyping with immediate colposcopy referral for HPV-16 or -18 positive and repeat HPV testing at 12months for non-HPV-16 or -18 positive ($78,010 per QALY gained). Differences in health benefits among candidate strategies were small, while resource use varied substantially. More effective strategies required a moderate increase in colposcopy referrals (e.g., a 9% increase for the preferred strategy) compared with current levels. CONCLUSION New applications of HPV testing may improve management of women with minor cervical lesions, yet are accompanied by a trade-off of increased follow-up procedures.
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Affiliation(s)
- Kine Pedersen
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, P.O. Box 1089 Blindern, 0317 Oslo, Norway
| | - Emily A Burger
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, P.O. Box 1089 Blindern, 0317 Oslo, Norway; Center for Health Decision Science, Harvard T.H. Chan School of Public Health, 718 Huntington Ave, 2nd Floor, Boston, MA 02115, USA.
| | - Stephen Sy
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, 718 Huntington Ave, 2nd Floor, Boston, MA 02115, USA
| | - Ivar S Kristiansen
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, P.O. Box 1089 Blindern, 0317 Oslo, Norway
| | - Jane J Kim
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, 718 Huntington Ave, 2nd Floor, Boston, MA 02115, USA
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Westre B, Giske A, Guttormsen H, Sørbye SW, Skjeldestad FE. 5-type HPV mRNA versus 14-type HPV DNA test: test performance, over-diagnosis and overtreatment in triage of women with minor cervical lesions. BMC Clin Pathol 2016; 16:9. [PMID: 27279798 PMCID: PMC4897822 DOI: 10.1186/s12907-016-0032-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 06/01/2016] [Indexed: 12/15/2022] Open
Abstract
Background Repeat cytology and HPV testing is used in triage of women with minor cytological lesions. The objective of this study was to evaluate 14-type HPV DNA and 5-type HPV mRNA testing in delayed triage of women with ASC-US/LSIL. Methods We compared a DNA test (Roche Cobas 4800) and an 5-type mRNA test (PreTect HPV-Proofer). In total 564 women were included in the study. Results The sensitivity among solved cases for CIN3+ were 100 % (15/15) for both tests. The sensitivity for CIN2+ of the HPV DNA test was 100 % (38/38) relative to 79 % (30/38) for the 5-type HPV mRNA test. The corresponding estimates of specificity for CIN2+ among solved cases were 84 % (393/466; 95 % CI: 81–88) and 91 % (451/498; 95 % CI: 88–93). The positive predictive values for CIN3+ were 13.5 % (15/111) for DNA+ and 19.5 % (15/77) for 5-type mRNA+. Significantly more women screened with 5-type mRNA than DNA returned to screening (81 % vs 71 %, p < 0.01). Subsequently, significantly fewer women were referred for colposcopy/biopsies/treatment (19 % (105/564) vs 29 % (165/564), p < 0.01). Conclusions 5-type HPV mRNA is more specific than 14-type HPV DNA in delayed triage of women with ASC-US/LSIL. The referral rate for colposcopy was 57 % higher for DNA+ relative to mRNA+ cases (165 vs 105), with the same detection rate of CIN3+, but the 5-type mRNA test had lower sensitivity for CIN2+. It is important to consider the trade-off between sensitivity and specificity of the diagnostic test when designing screening algorithms.
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Affiliation(s)
- Bjørn Westre
- Department of Pathology, Ålesund Hospital, Møre and Romsdal Health Trust, Ålesund, Norway
| | - Anita Giske
- Department of Pathology, Ålesund Hospital, Møre and Romsdal Health Trust, Ålesund, Norway
| | - Hilde Guttormsen
- Department of Pathology, Ålesund Hospital, Møre and Romsdal Health Trust, Ålesund, Norway
| | | | - Finn Egil Skjeldestad
- Research Group Epidemiology of Chronic Diseases, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Pedersen K, Sørbye SW, Kristiansen IS, Burger EA. Using novel biomarkers to triage young adult women with minor cervical lesions: a cost-effectiveness analysis. BJOG 2016; 124:474-484. [PMID: 27264207 DOI: 10.1111/1471-0528.14135] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the short-term consequences and cost-effectiveness associated with the use of novel biomarkers to triage young adult women with minor cervical cytological lesions. DESIGN Model-based economic evaluation using primary epidemiological data from Norway, supplemented with data from European and American clinical trials. SETTING Organised cervical cancer screening in Norway. POPULATION Women aged 25-33 years with minor cervical cytological lesions detected at their primary screening test. METHODS We expanded an existing simulation model to compare 12 triage strategies involving alternative biomarkers (i.e. reflex human papillomavirus (HPV) DNA/mRNA testing, genotyping, and dual staining) with the current Norwegian triage guidelines. MAIN OUTCOME MEASURES The number of high-grade precancers detected and resource use (e.g. monetary costs and colposcopy referrals) for a single screening round (3 years) for each triage strategy. Cost-efficiency, defined as the additional cost per additional precancer detected of each strategy compared with the next most costly strategy. RESULTS Five strategies were identified as cost-efficient, and are projected to increase the precancer detection rate between 18 and 57%, compared with current guidelines; however, the strategies did not uniformly require additional resources. Strategies involving HPV mRNA testing required fewer resources, whereas HPV DNA-based strategies detected >50% more precancers, but were more costly and required twice as many colposcopy referrals compared with the current guidelines. CONCLUSION Strategies involving biomarkers to triage younger women with minor cervical cytological lesions have the potential to detect additional precancers, yet the optimal strategy depends on the resources available as well as decision-makers' and women's acceptance of additional screening procedures. TWEETABLE ABSTRACT Women with minor cervical lesions may be triaged more accurately and effectively using novel biomarkers.
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Affiliation(s)
- K Pedersen
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - S W Sørbye
- Department of Clinical Pathology, University Hospital of North Norway, Tromsø, Norway
| | - I S Kristiansen
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - E A Burger
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.,Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Ho CM, Pan KY, Chen YY, Huang CY, Chen YL, Chang SF. Clinical performance of multiplex high-risk e6 mrna expression in comparison with hpv dna subtypes for the identification of women at risk of cervical cancer. J Med Virol 2015; 87:1404-12. [PMID: 25940199 DOI: 10.1002/jmv.24194] [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: 12/03/2014] [Revised: 01/21/2015] [Accepted: 02/18/2015] [Indexed: 11/09/2022]
Abstract
We compared multiplex E6 messenger ribonucleic acid (mRNA) tests using real-time quantitative reverse transcriptase polymerase chain reactions (PCR) with human papillomavirus (HPV) DNA subtypes using a MY11/GP6+ PCR-based reverse-blot assay to identify cervical intraepithelial neoplasias of grade 2 or worse (CIN2+). In total, 684 women were studied, of whom 377 (55%) were diagnosed with CIN2+ histologically. The specificity of HPV mRNA to predict histological CIN2+ was higher than that of HPV DNA (81.3% vs. 44.2%). The odds ratios (ORs) to predict histological CIN2+ in women with positive for type 16, 18, 31, and 45 E6 mRNA or by HPV DNA detection were 7.1 (95% confidence interval [CI] 3.9-13.1) and 2.5 (95%CI 1.9-3.5), respectively, compared to those with negative for E6 mRNA or HPV DNA. The OR to predict histological CIN2+ in women with a cytological grade <CIN2+ and positive for type 16, 18, 31, and 45 E6 mRNA was 9.7 (95%CI 3.2-29.2), compared to those with a cytological grade <CIN2+, and negative for E6 mRNA (OR = 1), those with a cytological grade CIN2+, and negative for mRNA (OR = 6.9, 95%CI 4.4-10.8), and those with a cytological grade CIN2+ and positive for mRNA (OR = 28.0, 95%CI 9.8-79.6). As a HPV DNA positive triage, the OR to predict histological CIN2+ in women with a cytological grade <CIN2+ and positive for mRNA was higher than those with negative for mRNA (OR:12.8 [95%CI 3.6-5.4] vs. OR:1.6 [95%CI 0.9-2.9]). In conclusion, multiplex HPV E6 mRNA detection can be used as a triage for women with cytological grade <CIN2+.
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Affiliation(s)
- Chih-Ming Ho
- Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.,School of Medicine, Fu Jen Catholic University, Hsinchuang, New Taipei City, Taiwan.,School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kui-You Pan
- King Car Food Industrial Co, Ltd, Yuan Shan Research Institute, Yilan, Taiwan
| | - Yun-Yuan Chen
- Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.,Research Division, Taiwan Blood Services Foundation, Taipei, Taiwan
| | - Chia-Yen Huang
- Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
| | - Yu-Li Chen
- Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan
| | - Shwu-Fen Chang
- Graduate Institute of Medical Sciences, School of Medicine, Taipei Medical University, Taipei, Taiwan
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10
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Origoni M, Cristoforoni P, Carminati G, Stefani C, Costa S, Sandri MT, Mariani L, Preti M. E6/E7 mRNA testing for human papilloma virus-induced high-grade cervical intraepithelial disease (CIN2/CIN3): a promising perspective. Ecancermedicalscience 2015; 9:533. [PMID: 26015802 PMCID: PMC4435751 DOI: 10.3332/ecancer.2015.533] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Indexed: 11/15/2022] Open
Abstract
Since the introduction of biomolecular testing for the identification of high-risk human papillomavirus DNA (hrHPV-DNA) in cervical cancer preventive strategies, many interesting aspects have emerged in this field; firstly, HPV-DNA testing has been demonstrated to have better sensitivity than conventional cytology in several settings: screening, triage of ASC-US and in follow-up after treatment. Despite this, some limitations of these new technologies have also been underlined: the major issue is the low specificity of the tests, which cannot discriminate between regressive and progressive infections. Thus, recent research has moved the attention towards novel markers of progression that could more precisely detect cases at real risk of cancer development. In view of the fact that progression to cancer is dependable of the E6/E7 proteins integration and transforming action, the overexpression of E6/E7 transcripts has been seen as a valuable marker of this risk. This review aims to summarise the literature data on this topic and to provide a clear view of the emerging perspectives.
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Affiliation(s)
- Massimo Origoni
- Department of Gynaecology & Obstetrics, Vita Salute San Raffaele University, School of Medicine, Milano 20132, Italy
| | | | - Guia Carminati
- Department of Gynaecology & Obstetrics, Vita Salute San Raffaele University, School of Medicine, Milano 20132, Italy
| | - Chiara Stefani
- Department of Gynaecology & Obstetrics, Vita Salute San Raffaele University, School of Medicine, Milano 20132, Italy
| | | | - Maria Teresa Sandri
- Division of Laboratory Medicine, European Institute of Oncology, Milano 20141, Italy
| | - Luciano Mariani
- HPV-UNIT, Regina Elena National Cancer Institute, Roma 00144, Italy
| | - Mario Preti
- Unit of Preventive Gynaecology, European Institute of Oncology, Milano 20141, Italy
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Duvlis S, Popovska-Jankovic K, Arsova ZS, Memeti S, Popeska Z, Plaseska-Karanfilska D. HPV E6/E7 mRNA versus HPV DNA biomarker in cervical cancer screening of a group of Macedonian women. J Med Virol 2015; 87:1578-86. [PMID: 25880030 DOI: 10.1002/jmv.24199] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2015] [Indexed: 11/07/2022]
Abstract
High risk types of human papillomaviruses E6/E7 oncogenes and their association with tumor suppressor genes products are the key factors of cervical carcinogenesis. This study proposed them as specific markers for cervical dysplasia screening. The aim of the study is to compare the clinical and prognostic significance of HPV E6/E7 mRNA as an early biomarker versus HPV DNA detection and cytology in triage of woman for cervical cancer. The study group consists of 413 women: 258 NILM, 26 ASC-US, 81 LSIL, 41 HSIL, and 7 unsatisfactory cytology. HPV4AACE screening, real-time multiplex PCR and MY09/11 consensus PCR primers methods were used for the HPV DNA detection. The real-time multiplex nucleic acid sequence-based assay (NucliSENS EasyQ HPV assay) was used for HPV E6/E7 mRNA detection of the five most common high risk HPV types in cervical cancer (16, 18, 31, 33, and 45). The results show that HPV E6/E7 mRNA testing had a higher specificity 50% (95% CI 32-67) and positive predictive value (PPV) 62% (95% CI 46-76) for CIN2+ compared to HPV DNA testing that had specificity of 18% (95% CI 7-37) and PPV 52% (95% CI 39-76) respectively. The higher specificity and PPV of HPV E6/E7 mRNA testing are valuable in predicting insignificant HPV DNA infection among cases with borderline cytological finding. It can help in avoiding aggressive procedures (biopsies and over-referral of transient HPV infections) as well as lowering patient's anxiety and follow up period.
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Affiliation(s)
- Sotirija Duvlis
- Institute of Public Health of R. Macedonia, Skopje, Republic of Macedonia
| | - Katerina Popovska-Jankovic
- Research Center for Genetic Engineering and Biotechnology "Georgi D. Efremov", Macedonian Academy of Science and Arts, Skopje, Republic of Macedonia
| | | | - Shaban Memeti
- Institute of Public Health of R. Macedonia, Skopje, Republic of Macedonia
| | - Zaneta Popeska
- Faculty of Computer Science and Engineering, Ss. Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Dijana Plaseska-Karanfilska
- Research Center for Genetic Engineering and Biotechnology "Georgi D. Efremov", Macedonian Academy of Science and Arts, Skopje, Republic of Macedonia
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Liu Q, Lin X, Lin L, Yi L, Li H, Lin JM. A comparative study of three different nucleic acid amplification techniques combined with microchip electrophoresis for HPV16 E6/E7 mRNA detection. Analyst 2015; 140:6736-41. [DOI: 10.1039/c5an00944h] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The development of a high-throughput and automatic system by combining gene amplification with MCE for HPV16 E6/E7 mRNA screening is reported.
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Affiliation(s)
- Quanli Liu
- State Key Laboratory of Chemical Resource Engineering
- Beijing University of Chemical Technology
- Beijing 100029
- China
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation
| | - Xuexia Lin
- State Key Laboratory of Chemical Resource Engineering
- Beijing University of Chemical Technology
- Beijing 100029
- China
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation
| | - Luyao Lin
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation
- Department of Chemistry
- Tsinghua University
- Beijing 100084
- P. R. China
| | - Linglu Yi
- State Key Laboratory of Chemical Resource Engineering
- Beijing University of Chemical Technology
- Beijing 100029
- China
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation
| | - Haifang Li
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation
- Department of Chemistry
- Tsinghua University
- Beijing 100084
- P. R. China
| | - Jin-Ming Lin
- Beijing Key Laboratory of Microanalytical Methods and Instrumentation
- Department of Chemistry
- Tsinghua University
- Beijing 100084
- P. R. China
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