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Sun S, Wang Y, Liu Y, Leng Z, Jiang Y, Liang Y, Jiang Z. Telomerase reverse transcriptase gene polymorphisms and cervical cancer susceptibility in high-risk human papillomavirus-infected women. J Obstet Gynaecol Res 2024; 50:95-102. [PMID: 37857487 DOI: 10.1111/jog.15815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/08/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE To investigate the relationship between Human telomerase reverse transcriptase (hTERT) gene polymorphisms and the susceptibility and clinicopathological parameters of cervical cancer in women infected with high-risk human papillomavirus (HR-HPV). METHOD A total of 380 patients with HPV-infected cervical cancer who were admitted to the Jilin province Maternal and Child Health Care Hospital (Jilin province Obstetrics Quality Control Center) from July 2019 to July 2023 were selected as case group, and 408 women with negative HPV results in the cervical cancer screening results of the physical examination in the same hospital were selected as the control group. Restriction fragment length polymorphisms polymerase chain reaction was used to detect the polymorphisms of hTERT, and its relationship with the susceptibility to high-risk HPV infection and clinicopathological parameters in patients with cervical cancer was analysed. RESULTS Individuals carrying the GA and AA genotypes of rs2736122 were significantly associated with an increased risk of cervical cancer when compared with the GG genotype and the adjusted ORs were 0.53 (0.37-0.79) for the AA genotype and 0.73 (0.59-0.88) for the A allele genotype. Besides, GG genotype or G allele of rs2853677 presented a significant influence on cervical cancer, with ORs of 0.59 (0.41-0.86) and 10.77 (0.63-0.94), respectively, when compared with the AA genotype. And rs2853677 have statistically significant difference in tumour diameter and degree of differentiation subgroup(p < 0.05). CONCLUSION The results of this study indicate that the hTERT gene rs2736122AA and rs2853677 GG genotypes can increase the susceptibility of high-risk HPV infection in cervical cancer patients. And rs2853677 is related to tumours above 4 cm and highly differentiated tumours. But both have nothing to do with the patient's chemotherapy sensitivity.
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Affiliation(s)
- Shuang Sun
- Clinical Laboratory Center of Maternal and Child Health Hospital of Jilin Province, Changchun, China
| | - Yuhong Wang
- Clinical Laboratory Center of Maternal and Child Health Hospital of Jilin Province, Changchun, China
| | - Ying Liu
- Clinical Laboratory Center of Maternal and Child Health Hospital of Jilin Province, Changchun, China
| | - Zongxiang Leng
- Gynecology Clinic of Maternal and Child Health Hospital of Jilin Province, Changchun, China
| | - Yujuan Jiang
- Gynecology Clinic of Maternal and Child Health Hospital of Jilin Province, Changchun, China
| | - Yu Liang
- Gynecology Clinic of Maternal and Child Health Hospital of Jilin Province, Changchun, China
| | - Zhe Jiang
- The Second Affiliated Hospital of Jilin University, Changchun, China
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İnce O, Uysal E, Durak G, Önol S, Dönmez Yılmaz B, Ertürk ŞM, Önder H. Prediction of carcinogenic human papillomavirus types in cervical cancer from multiparametric magnetic resonance images with machine learning-based radiomics models. Diagn Interv Radiol 2023; 29:460-468. [PMID: 36994859 PMCID: PMC10679607 DOI: 10.4274/dir.2022.221335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 11/16/2022] [Indexed: 01/15/2023]
Abstract
PURPOSE This study aimed to evaluate the potential of machine learning-based models for predicting carcinogenic human papillomavirus (HPV) oncogene types using radiomics features from magnetic resonance imaging (MRI). METHODS Pre-treatment MRI images of patients with cervical cancer were collected retrospectively. An HPV DNA oncogene analysis was performed based on cervical biopsy specimens. Radiomics features were extracted from contrast-enhanced T1-weighted images (CE-T1) and T2-weighted images (T2WI). A third feature subset was created as a combined group by concatenating the CE-T1 and T2WI subsets. Feature selection was performed using Pearson's correlation coefficient and wrapper- based sequential-feature selection. Two models were built with each feature subset, using support vector machine (SVM) and logistic regression (LR) classifiers. The models were validated using a five-fold cross-validation technique and compared using Wilcoxon's signed rank and Friedman's tests. RESULTS Forty-one patients were enrolled in the study (26 were positive for carcinogenic HPV oncogenes, and 15 were negative). A total of 851 features were extracted from each imaging sequence. After feature selection, 5, 17, and 20 features remained in the CE-T1, T2WI, and combined groups, respectively. The SVM models showed 83%, 95%, and 95% accuracy scores, and the LR models revealed 83%, 81%, and 92.5% accuracy scores in the CE-T1, T2WI, and combined groups, respectively. The SVM algorithm performed better than the LR algorithm in the T2WI feature subset (P = 0.005), and the feature sets in the T2WI and the combined group performed better than CE-T1 in the SVM model (P = 0.033 and 0.006, respectively). The combined group feature subset performed better than T2WI in the LR model (P = 0.023). CONCLUSION Machine learning-based radiomics models based on pre-treatment MRI can detect carcinogenic HPV status with discriminative accuracy.
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Affiliation(s)
- Okan İnce
- Clinic of Radiology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşcığlu City Hospital, İstanbul, Turkey
| | - Emre Uysal
- Clinic of Radiation Oncology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşcığlu City Hospital, İstanbul, Turkey
| | - Görkem Durak
- Department of Radiology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Suzan Önol
- Clinic of Radiology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşcığlu City Hospital, İstanbul, Turkey
| | - Binnur Dönmez Yılmaz
- Clinic of Radiation Oncology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşcığlu City Hospital, İstanbul, Turkey
| | - Şükrü Mehmet Ertürk
- Department of Radiology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Hakan Önder
- Clinic of Radiology, University of Health Sciences Turkey, Prof. Dr. Cemil Taşcığlu City Hospital, İstanbul, Turkey
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Dhanasekaran K, Tamang H, Pradhan S, Lhamu R, Hariprasad R. Challenges in setting up a primary human papillomavirus-DNA testing facility in a lower and middle income country: lessons learned from a pilot programme. Ecancermedicalscience 2022; 16:1492. [PMID: 36819827 PMCID: PMC9935055 DOI: 10.3332/ecancer.2022.1492] [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: 09/06/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Detection of high-risk human papillomavirus (hrHPV) is the most sensitive test for the screening of cervical cancer. Although most high-income countries have adopted this strategy in their screening programme, there are a lot of barriers in low and middle-income countries (LMICs) in setting up this facility for screening. The lessons learned based on this experience can be useful for other LMICs in their first steps to integrate HPV testing into a screening programme. Methods HPV testing using self-sampling was offered to eligible women residing in one district of Sikkim state. To implement the same, a testing laboratory was set up in the district and the challenges faced are listed. Results The cost of testing equipment, sampler and cold storage was beyond the budget capping. Setting up of the HPV testing lab accessible to study sites and referral centre was a difficult decision to make. Training the health care providers in their proficiency in triaging and treatment was challenging. Coordinating with community health workers and beneficiaries for effective screening and establishing referral linkages was not easy, as we expected. The cost of transportation, consumables and contingencies was higher due to the difficult terrain. Conclusion The cost of the equipment and consumables for primary HPV screening can be reduced in bulk purchases through negotiations. Adequate knowledge of the terrain and economic implications of the area of interest is crucial during the budgeting of the programme. Collaborating with the state government, integration with the existing health system and repurposing the available resources are key for success. The barriers faced during implementation are stepping stones for improvement.
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Affiliation(s)
- Kavitha Dhanasekaran
- Division of Clinical Oncology, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh 201301, India,https://orcid.org/0000-0002-3756-3419
| | - Harki Tamang
- Department of Health and Welfare, Government of Sikkim, Gangtok, Sikkim 737101, India
| | - Sangeeta Pradhan
- Department of Health and Welfare, Government of Sikkim, Gangtok, Sikkim 737101, India
| | - Rinzing Lhamu
- Department of Health and Welfare, Government of Sikkim, Gangtok, Sikkim 737101, India
| | - Roopa Hariprasad
- Division of Clinical Oncology, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh 201301, India,https://orcid.org/0000-0003-2032-3432
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Cerqueira RS, Dos Santos HLPC, Prado NMDBL, Bittencourt RG, Biscarde DGDS, Dos Santos AM. [Control of cervical cancer in the primary care setting in South American countries: systematic reviewControl del cáncer cervicouterino en los servicios de atención primaria de salud en los países de América del Sur: revisión sistemática]. Rev Panam Salud Publica 2022; 46:e107. [PMID: 36016837 PMCID: PMC9395576 DOI: 10.26633/rpsp.2022.107] [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: 08/12/2021] [Accepted: 03/28/2022] [Indexed: 11/24/2022] Open
Abstract
Objetivo. Descrever as estratégias para prevenção e controle do câncer do colo do útero (CCU) na atenção primária à saúde (APS) na América do Sul. Métodos. Revisão de literatura em duas etapas: revisão documental em sites governamentais de Argentina, Bolívia, Brasil, Chile, Colômbia, Equador, Paraguai, Peru, Uruguai e Venezuela; e revisão sistemática da literatura nas bases LILACS, MEDLINE, Scopus, SciELO e Science Direct. Resultados. Foram incluídos 21 documentos institucionais (planos, guias de prática e diretrizes nacionais) e 25 artigos. Todos os países tinham taxas elevadas de morbimortalidade por CCU. Predominou o rastreamento oportunístico na APS, embora os documentos disponíveis sinalizassem intenções e estratégias para diagnóstico precoce e acompanhamento longitudinal dos casos suspeitos e confirmados, preferencialmente na rede pública. Todos os países adotavam uma concepção abrangente de APS, embora o processo de implementação estivesse em estágios heterogêneos e predominassem a focalização e a seletividade. Destaca-se pior acesso ao rastreamento para mulheres de regiões rurais ou remotas e para povos originários. A indisponibilidade de serviços de APS próximos às residências/comunidade foi uma importante barreira para o rastreamento do CCU. Conclusões. A fragmentação dos sistemas de saúde e a segmentação na oferta de serviços são obstáculos para a prevenção e o controle do CCU na América do Sul. São necessários programas organizados de rastreamento do CCU e a incorporação de busca ativa para realização do Papanicolaou via APS. A interculturalidade nas práticas e a formulação de políticas numa perspectiva interseccional são fundamentais para superar as iniquidades no controle do CCU nos países sul-americanos.
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Affiliation(s)
- Raisa Santos Cerqueira
- Universidade Federal da Bahia Programa de Pós-Graduação em Saúde Coletiva Vitória da Conquista (BA) Brasil Universidade Federal da Bahia, Programa de Pós-Graduação em Saúde Coletiva, Vitória da Conquista (BA), Brasil
| | - Hebert Luan Pereira Campos Dos Santos
- Universidade Federal da Bahia Programa de Pós-Graduação em Saúde Coletiva Vitória da Conquista (BA) Brasil Universidade Federal da Bahia, Programa de Pós-Graduação em Saúde Coletiva, Vitória da Conquista (BA), Brasil
| | - Nilia Maria de Brito Lima Prado
- Universidade Federal da Bahia Programa de Pós-Graduação em Saúde Coletiva Vitória da Conquista (BA) Brasil Universidade Federal da Bahia, Programa de Pós-Graduação em Saúde Coletiva, Vitória da Conquista (BA), Brasil
| | - Rebecca Gusmão Bittencourt
- Universidade Federal da Bahia Programa de Pós-Graduação em Saúde Coletiva Vitória da Conquista (BA) Brasil Universidade Federal da Bahia, Programa de Pós-Graduação em Saúde Coletiva, Vitória da Conquista (BA), Brasil
| | - Daniela Gomes Dos Santos Biscarde
- Universidade Federal da Bahia Escola de Enfermagem Salvador (BA) Brasil Universidade Federal da Bahia, Escola de Enfermagem, Salvador (BA), Brasil
| | - Adriano Maia Dos Santos
- Universidade Federal da Bahia Programa de Pós-Graduação em Saúde Coletiva Vitória da Conquista (BA) Brasil Universidade Federal da Bahia, Programa de Pós-Graduação em Saúde Coletiva, Vitória da Conquista (BA), Brasil
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Kolek CO, Opanga SA, Okalebo F, Birichi A, Kurdi A, Godman B, Meyer JC. Impact of Parental Knowledge and Beliefs on HPV Vaccine Hesitancy in Kenya-Findings and Implications. Vaccines (Basel) 2022; 10:vaccines10081185. [PMID: 35893833 PMCID: PMC9332201 DOI: 10.3390/vaccines10081185] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023] Open
Abstract
Cervical cancer can be prevented by human papillomavirus (HPV) vaccination. However, parents can have concerns about vaccinating their daughters. Consequently, there is a need to identify prevalence and risk factors for HPV vaccine hesitancy among parents in Kenya. A descriptive cross-sectional study was conducted among parents with children aged 9−14 years attending a leading referral hospital in Kenya. Data on sociodemographic traits, HPV knowledge, beliefs and vaccine hesitancy were collected. Out of 195 participants, 183 (93.5%) were aged >30 years. Thirty-four (46.4%) of males and 39 (35.1%) of females did not know that the vaccine is given to prevent HPV infection. Encouragingly, levels of vaccine acceptance were high (90%) although one-third (37.9%) had a negative perception about the effectiveness of the vaccine, with vaccine hesitancy attributed to safety concerns (76%) and feelings that the child was too young (48%). Positive beliefs and knowledge of the vaccine were positively associated with parental willingness to vaccinate their children. Low levels of parenteral education and a younger age among mothers were negatively associated with willingness to vaccinate. Most parents (59%) would consult their daughters before vaccination, and 77% (n = 150) recommended early sex education. Despite low knowledge levels, there was high parental willingness to have their children vaccinated.
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Affiliation(s)
| | - Sylvia A. Opanga
- Department of Pharmacy, University of Nairobi, Nairobi 00202, Kenya;
- Correspondence: (S.A.O.); or (B.G.)
| | - Faith Okalebo
- Department of Pharmacy, University of Nairobi, Nairobi 00202, Kenya;
| | - Alfred Birichi
- Directorate of Pharmaceutical Services, Kenyatta National Hospital, Nairobi 00202, Kenya;
| | - Amanj Kurdi
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK;
- Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil 44001, Iraq
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
| | - Brian Godman
- Department of Pharmacoepidemiology, Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK;
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman 13306, United Arab Emirates
- Correspondence: (S.A.O.); or (B.G.)
| | - Johanna C. Meyer
- Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria 0208, South Africa;
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Machalek D, Rees H, Chikandiwa A, Munthali R, Travill D, Mbulawa Z, Petoumenos K, Delany-Moretlwe S, Kaldor J. Impact of one and two human papillomavirus (HPV) vaccine doses on community-level HPV prevalence in South African adolescent girls: study protocol and rationale for a pragmatic before-after design. BMJ Open 2022; 12:e059968. [PMID: 35144959 PMCID: PMC8845310 DOI: 10.1136/bmjopen-2021-059968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Vaccines against human papillomavirus (HPV) are the key to controlling cervical cancer in low/middle-income countries (LMICs) where incidence is highest, but there have been limited data from these settings on programme impact on HPV prevalence, and none in a population with endemic HIV infection. Furthermore, for many LMICs, the currently recommended two-dose schedule is difficult to deliver at scale, so there is mounting interest in a single-dose schedule. METHODS AND ANALYSIS The Human Papillomavirus One and Two-Dose Population Effectiveness Study is a hybrid impact evaluation of the national South African HPV vaccination programme, which has targeted grade 4 girls aged at least 9 years in public schools with two doses of vaccine since 2014, and a single-dose vaccine 'catch-up' programme delivered in one district in 2019. Impacts of both schedules on the prevalence of type-specific HPV infection will be measured using repeat cross-sectional surveys in adolescent girls and young women aged 17-18 years recruited at primary healthcare clinics in the four provinces. A baseline survey in 2019 measured HPV prevalence in the cohort who were ineligible for vaccination because they were already above the target age or grade under either the national programme or the single-dose programme in the selected district. HPV prevalence surveys are repeated in 2021 in the selected district, and in 2023 in all four provinces. We will calculate prevalence ratios to compare the prevalence of HPV types 16 and 18 in the single-dose (2021) and two-dose (2023) cohorts, with the vaccine-ineligible (2019) cohort. ETHICS AND DISSEMINATION The project was approved by the University of the Witwatersrand Human Research Ethics Committee (HREC #181005), and the University of New South Wales HREC (#181-005). Findings will be disseminated through peer-reviewed journals, scientific meetings, reports and community forums.
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Affiliation(s)
- Dorothy Machalek
- Kirby Institute, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
- Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Helen Rees
- Wits RHI, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Admire Chikandiwa
- Wits RHI, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Richard Munthali
- Wits RHI, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Danielle Travill
- Wits RHI, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Zizipho Mbulawa
- UCT-MRC Clinical Gynaecological Cancer Research Centre, University of Cape Town, Rondebosch, Western Cape, South Africa
- Department of Laboratory Medicine and Pathology, Walter Sisulu University, Mthatha, Eastern Cape, South Africa
| | - Kathy Petoumenos
- Kirby Institute, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
| | | | - John Kaldor
- Kirby Institute, University of New South Wales-Kensington Campus, Sydney, New South Wales, Australia
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Chatzistamatiou K, Tsertanidou A, Moysiadis T, Mouchtaropoulou E, Pasentsis K, Skenderi A, Stamatopoulos K, Agorastos T. Comparison of different strategies for the triage to colposcopy of women tested high-risk HPV positive on self-collected cervicovaginal samples. Gynecol Oncol 2021; 162:560-568. [PMID: 34210517 DOI: 10.1016/j.ygyno.2021.06.020] [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: 04/08/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To identify the optimal strategy for the triage of women who test high-risk (hr) HPV positive on self-collected cervicovaginal samples. METHODS This is a diagnostic accuracy sub-analysis of the GRECOSELF study, which reported on HPV-DNA testing with self-sampling in Greece. More than 13,000 women, 25-60 years old, who resided in rural areas of Greece, provided a self-collected cervicovaginal sample. Samples were tested for HPV-DNA and HPV16/18 genotyping with the cobas® HPV test (Roche® Molecular Systems, Pleasanton, CA, USA). HrHPV positive women were referred for colposcopy. Prior to colposcopy a physician-collected sample was obtained for cytology. After colposcopy/biopsy, women were classified as having cervical disease or not, and treated accordingly. RESULTS Out of 1070 hrHPV positive women, 773 were subjected to colposcopy. Seventeen triage strategies, combining HPV16/18 genotyping and cytology, were investigated. The strategy referring to colposcopy women positive for HPV16 regardless of the cytology report, and women positive for other hrHPVs, in case of a subsequent atypical squamous cells of undetermined significance or worse (ASCUS+) cytology report, presented optimal trade-off; sensitivity 96.36% [(95%CI: (91.41-100.0)], positive predictive value (PPV) 27.46% [95%CI: (21.16-33.76)], and number of colposcopies required to detect one case of Cervical Intraepithelial Neoplasia grade-2 or worse (CIN2+) 3.64. CONCLUSIONS The optimal strategy for the triage to colposcopy of hrHPV positive women, detected with the cobas® HPV test on self-collected cervicovaginal samples, is referring all HPV16 positive women directly to colposcopy, and women positive for HPV18 or other hrHPVs only after an ASCUS or worse cytology report.
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Affiliation(s)
- Kimon Chatzistamatiou
- 1(st) Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
| | - Athena Tsertanidou
- 3(th) Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece
| | - Theodoros Moysiadis
- Institute of Applied Biosciences, Centre for Research & Technology - Hellas, Thessaloniki, Greece; Department of Computer Science, School of Sciences and Engineering, University of Nicosia, 2417 Nicosia, Cyprus
| | | | - Konstantinos Pasentsis
- Institute of Applied Biosciences, Centre for Research & Technology - Hellas, Thessaloniki, Greece
| | - Alkmini Skenderi
- Department of Cytology, Hippokratio General Hospital, Thessaloniki, Greece
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Centre for Research & Technology - Hellas, Thessaloniki, Greece
| | - Theodoros Agorastos
- Department of Gynecologic Oncology, St. Luke's Hospital, Thessaloniki, Greece
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Li YX, Luo HX, Wang W, Wang Z, Zhao WH, Hao M. Diagnostic accuracy of novel folate receptor-mediated staining solution detection (FRD) for CIN2+: A systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e26004. [PMID: 34011097 PMCID: PMC8137059 DOI: 10.1097/md.0000000000026004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/02/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Early detection and diagnosis of high-grade cervical intraepithelial neoplasia grade 2 or higher (CIN2+) is critical for a good prognosis and appropriate treatment. The chief aim of our study was to evaluate the diagnostic performance of folate receptor-mediated staining solution detection (FRD) for CIN2+. METHODS We conducted a systematic review and meta-analysis by searching the PubMed and EMBASE databases for studies published until May 2020, which assessed the diagnostic accuracy of FRD, human papilloma virus (HPV) testing, and ThinPrep cytology test (TCT) for the detection of CIN2+. Bivariate models were used to compare the diagnostic performance of FRD, HPV, and TCT. RESULTS Six studies involving 2817 patients were included in this meta-analysis. The pooled specificity of FRD was higher than that of HPV and TCT for detecting CIN2+ (0.65, 0.12, and 0.39, respectively). The summary area under the receiver operating characteristic curve values using FRD, HPV, and TCT for detecting CIN2+ were 0.79, 0.95, and 0.77, respectively, indicating that FRD was superior to TCT. The diagnostic odds ratios of FRD, HPV, and TCT were 6 (95% CI: 5-7), 3 (95% CI: 2-5), and 3 (95% CI: 2-4), respectively, demonstrating that FRD had good diagnostic accuracy. CONCLUSION FRD showed good diagnostic accuracy and higher specificity than HPV and TCT for detecting CIN2+. Based on our results, we propose that FRD could be a candidate for cervical screening, especially in underdeveloped countries.
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