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Sheng B, Yao D, Du X, Chen D, Zhou L. Establishment and validation of a risk prediction model for high-grade cervical lesions. Eur J Obstet Gynecol Reprod Biol 2023; 281:1-6. [PMID: 36521399 DOI: 10.1016/j.ejogrb.2022.12.005] [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: 06/15/2022] [Revised: 11/21/2022] [Accepted: 12/04/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To establish and validate a risk prediction model for cervical high-grade squamous intraepithelial lesions (HSIL). METHODS This retrospective study included patients who underwent cervical biopsies at the Cervical Disease Centre of Maternal and Child Hospital of Hubei Province between January 2021 and December 2021. RESULTS A total of 1630 patients were divided into the HSIL + cervical lesion group (n = 186) and the ≤ LSIL cervical lesions group (n = 1444). LSIL, ASC-H, HSIL and SCC, high-risk HPV, HPV16, HPV18/45, multiple HPV strains, acetowhite epithelium, atypical vessels, and mosaicity were independently associated with HSIL + lesions. These factors were used to establish a risk prediction model with a demonstrated area under the curve (AUC) of 0.851 and a C-index of 0.829. Calibration curve analysis showed that the model performed well, with a mean absolute error (MAE) of 0.005. The decision curve showed that the model created by combining the risk factors was more specific and sensitive than each predictive variable. CONCLUSION The model for predicting HSIL demonstrated promising predictive capability and might help identify patients requiring biopsy and treatment.
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Affiliation(s)
- Binyue Sheng
- Department of Gynaecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Hongshan, Wuhan, Hubei 430070, PR China
| | - Dongmei Yao
- Department of Gynaecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Hongshan, Wuhan, Hubei 430070, PR China.
| | - Xin Du
- Department of Gynaecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Hongshan, Wuhan, Hubei 430070, PR China
| | - Dejun Chen
- Department of Gynaecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Hongshan, Wuhan, Hubei 430070, PR China
| | - Limin Zhou
- Department of Gynaecology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Hongshan, Wuhan, Hubei 430070, PR China
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Salivary Biomarkers in Oral Squamous Cell Carcinoma: A Proteomic Overview. Proteomes 2022; 10:proteomes10040037. [PMID: 36412636 PMCID: PMC9680331 DOI: 10.3390/proteomes10040037] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) is one of the most frequent cancers worldwide. Endoscopic methods may be useful in the evaluation of oral injuries even though the diagnostic gold standard is a biopsy. Targeted screenings could be considered the best way to prevent the occurrence of oral cancer. Aimed to elucidate the potential identification of specific biomarkers of OSCC, the use of saliva is convenient and noninvasive. Many studies reported more than a hundred putative saliva biomarkers for OSCC, and proteogenomic approaches were fundamental to disclosing this issue. METHODS Relevant literature published in the last few years was systematically searched on PubMed and we focused on articles about the use and study of salivary biomarkers in the diagnostics of head and neck cancer (n = 110). Thereafter, we performed a selection focusing on diagnosis with salivary proteomics in OSCC (n = 8). RESULTS Saliva proteomics can be a source of biomarkers for OSCC. We reviewed literature of biomarker proteins in saliva that could also be evaluated as probable targets for non-invasive screening of oral neoplasm such as cytokines, matrix metalloproteinases, and acute-phase response proteins. CONCLUSIONS The measurement of salivary biomarkers is a highly hopeful technique for the diagnosis of OSCC. Proteogenomic approaches could permit an accurate and early diagnosis of OSCC. This review seeks to generate an up-to-date view on translational OSCC issues by raising awareness of researchers, physicians, and surgeons. Renewed clinical studies, which will validate the sensitivity and specificity of salivary biomarkers, are necessary to translate these results into possible strategies for early diagnosis of OSCC, thus improving patient outcomes.
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Ma G, Song G, Zou X, Shan X, Liu Q, Xia T, Zhou X, Zhu W. Circulating plasma microRNA signature for the diagnosis of cervical cancer. Cancer Biomark 2020; 26:491-500. [PMID: 31658043 DOI: 10.3233/cbm-190256] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine the utility of plasma microRNAs (miRNAs) as biomarkers in cervical cancer (CC). METHODS Some studies were conducted about the specific expression of plasma miRNAs in the diagnosis of CC. Plasma samples of 97 CC patients and 87 normal controls (NCs) were used to identify dysregulation of miRNAs in the training, testing, and external validation phases. Receiver operating characteristic (ROC) curves and area under the ROC curve (AUC) were used to evaluate the sensitivity and specificity of identified individual miRNAs and miRNA panels for the diagnosis of CC. Expression levels of specific miRNAs were also examined in plasma exosomes and tissue samples of CC patients. RESULTS Four plasma miRNAs (miR-146a-5p, miR-151a-3p, miR-2110 and miR-21-5p) which showed up-regulation were identified and validated in CC patients. A panel of the four miRNAs were constructed as potential diagnostic markers for CC. The AUCs of the panel of these four-miRNAs for the training, testing, and external validation phases were 0.911, 0.774, and 0.786, respectively. miR-146a-5p and miR-21-5p levels were all up-regulated in CC tissue specimens, whereas miR-146a-5p, miR-151a-3p, and miR-2110 levels were up-regulated in plasma exosomes. CONCLUSION The signature of the four-miRNAs identified in peripheral plasma is a promising novel biomarker for the diagnosis of CC.
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Affiliation(s)
- Ge Ma
- Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China.,Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Guoxin Song
- Department of Pathology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xuan Zou
- First Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xia Shan
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Respiration, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qingxie Liu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Tiansong Xia
- Breast Disease Center, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Zhou
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Zhu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Oncology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Wujiang, Jiangsu, China
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Abstract
High incidence of oral carcinoma and its late-stage presentation are the major global healthcare issues. The World Health Organization (WHO) has set early diagnosis and prevention of oral cancer as their primary objective. It is important to consider the time of oral screening, as it plays a pivotal role in understanding the disease prognosis. Critical signs and symptoms that can be identified during initial oral screening can improve the chances of patient's survival. Reports suggest that socio-economic factors, lack of public awareness and delays from primary health care centers are few of the major parameters that contribute to patient's mortality and morbidity. Conventional technique of visual examination of the oral lesion can effectively monitor patient mortality when exposed to risk factors. However, several disadvantages limit the clinical utility of this technique. Thus, screening aids that efficiently differentiate between a benign and malignant lesion as well as deliver information about early OSCC can ameliorate the complications associated with oral cancer diagnosis. Recent advances in optical imaging systems, such as tissue-fluorescence imaging and optical coherence tomography have been proved to be considerably efficient. Additionally, extensive research has been directed towards nanoparticle-based immunosensors, DNA analysis, and salivary proteomics. However, lack of proper clinical trials and correlation with biopsy result hinder the usage of these screening techniques in clinics. In this review, we highlight the importance of early diagnosis of oral cancer as well as discuss about the effectiveness and limitations of the recent diagnostic aids. It can be stated that public awareness regarding routine oral examination and employing screening methods that are non-invasive, robust, and economic, would enhance early stage diagnosis of oral cancer and have a positive impact on patient's survival.
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Han S, Yang W, Li H. A study of the application of fiberoptic bronchoscopy combined with liquid-based cytology test in the early diagnosis of lung cancer. Oncol Lett 2018; 16:5807-5812. [PMID: 30344732 PMCID: PMC6176377 DOI: 10.3892/ol.2018.9372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 08/20/2018] [Indexed: 11/09/2022] Open
Abstract
Application value of fiberoptic bronchoscopy combined with liquid-based cytology test (LCT) in the early diagnosis of lung cancer was investigated. Clinical data of 901 patients who had suspicious lung space-occupying lesions and underwent bronchoscopy combined with LCT in Shanxi Provincial Cancer Hospital from June 2012 to June 2016 were retrospectively analyzed. Patients were divided into four groups to receive different fiberoptic bronchoscopies combined with LCT. Patients in Group A (n=276) received bronchoscopic washing cultures (BWC), Group B (n=204) received bronchoalveolar lavage (BAL), Group C (n=187) underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and Group D (n=234) underwent transbronchial lung biopsy (TBLB). All patients received pathological biopsy to confirm the lesions. The diagnostic results of lung cancer and the incidence rates of postoperative adverse reactions/complications were analyzed and compared among the four groups. Among 901 patients, 741 cases were pathologically diagnosed with lung cancer. In Group A, there were 224 cases diagnosed with lung cancer, of which 193 cases were successfully detected with a detection rate of 86.17% and a κ-value of 0.426. In Group B, 171 cases were diagnosed with lung cancer, of which 149 cases were successfully detected with a detection rate of 87.13% and a κ-value of 0.430. In Group C, 154 cases were diagnosed with lung cancer, of which 146 cases were successfully detected with a detection rate of 94.81% and a κ-value of 0.769. In Group D, 192 cases were diagnosed with lung cancer, of which 170 cases were successfully detected with a detection rate of 88.54% and a κ-value of 0.440. Therefore, we conclude that fiberoptic bronchoscopy combined with LCT technique is safe and reliable for the diagnosis of the early-stage lung cancer.
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Affiliation(s)
- Songyan Han
- Department of Respiration Disease, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi 030013, P.R. China
| | - Weihua Yang
- Department of Respiration Disease, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi 030013, P.R. China
| | - Hongwei Li
- Department of Radiation Oncology, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi 030013, P.R. China
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Shi WJ, Liu H, Wu D, Tang ZH, Shen YC, Guo L. E6/E7 proteins are potential markers for the screening and diagnosis of cervical pre-cancerous lesions and cervical cancer in a Chinese population. Oncol Lett 2017; 14:6251-6258. [PMID: 29113275 DOI: 10.3892/ol.2017.6932] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 03/14/2017] [Indexed: 12/14/2022] Open
Abstract
The present prospective study aimed to evaluate the effects of E6/E7 protein detection by western blotting on cervical cancer (CC) early screening compared with detection by Hybrid Capture 2 (HC2) test and ThinPrep cytological test (TCT) in a Chinese population. A total of 450 cases of cervical intraepithelial neoplasia (CIN) suspected samples (positive in ≥1 indicator of TCT and HC2 test) were recruited from women who were treated at the International Peace Maternity and Child Health Hospital (Shanghai, China) from March 2014 to February 2015. Each sample was analyzed by cytological test. In addition, human papillomavirus (HPV) DNA examination by Hybrid Capture Tube test and E6/E7 protein expression detection by western blotting were performed in all samples, as well as histologic diagnosis to determine the stage of CIN. The results revealed that, for the diagnosis of CIN2+, although the sensitivity of E6/E7 protein detection was lower than that of HC2 test (71.3 vs. 96.6%, respectively), the specificity was markedly improved (67.6 vs. 5.9%, respectively). Compared with that of TCT, the sensitivity of E6/E7 protein detection was much higher (36.2 vs. 71.3%, respectively), but the specificity was lower (88.2 vs. 67.6%, respectively). In the present study, HPV E6/E7 protein expression was evaluated as a potential new biomarker for CC, with satisfactory diagnostic values for HPV types 16 and 18. The relative diagnostic value may be further improved by combination of E6/E7 messenger RNA detection.
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Affiliation(s)
- Wen-Jing Shi
- Department of Clinical Laboratory, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200030, P.R. China
| | - Hao Liu
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hong Kong, SAR 999077, P.R. China
| | - Dan Wu
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200030, P.R. China
| | - Zhen-Hua Tang
- Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200030, P.R. China
| | - Yu-Chen Shen
- Department of Clinical Laboratory, International Peace Maternity and Child Health Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200030, P.R. China
| | - Lin Guo
- Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai Medical College of Fudan University, Shanghai 200032, P.R. China
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Yang J, Wu D, Li Z, Wu J, Ding L, Xu Y. Exploration of treatment strategies for normal cytology smears with reactive cellular changes. Eur J Obstet Gynecol Reprod Biol 2015; 194:92-5. [PMID: 26344350 DOI: 10.1016/j.ejogrb.2015.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 07/02/2015] [Accepted: 08/06/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the use of high-risk humanpapillomavirus (HR-HPV) DNA testing in women who have normal cytology result with reactive cellular changes to identify high risk patients of developing precancerous cervical lesions and cervical cancer. STUDY DESIGN Outpatient patients with normal liquid-based cytology (LCT) results showing reactive cellular changes (case group, n=1085) and normal LCT without reactive cellular changes (control group, n=1085) were recruited from cervical clinics at the International Peace Maternity & Child Health Hospital from January 2012 to December 2013. The HPV status and cervical biopsy pathology results were analyzed. RESULTS The HR-HPV positive rate of the case group (598/1085) was higher than that of the control group (163/1085) (P<0.001). HR-HPV prevalence among CIN1, CIN2, CIN3 and cervical cancer was 73%, 87%, 100%, and 100% respectively (P<0.05). In patients with positive HR-HPV results, more CIN2+ were found significantly in case group (37/598) than those in control group (3/163), P=0.027. The sensitivity of diagnosis of CIN2+ lesions by HR-HPV testing was 92.5%, the specificity was 36%, the positive predicted value was 8.6%, and the negative predictive value was 98.6%. The incidence of CIN2+ lesions was not different among different age groups (P>0.05). CONCLUSION Reactive cellular changes in normal cervical smears should be further investigated. HR-HPV testing could be used as an effective triage in cases of reactive cellular changes. Colposcopy is recommended for those cases showing reactive cellular changes combined with HR-HPV positivity to reduce the risk of failure to diagnose cervical cancer and precancerous lesions.
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Affiliation(s)
- Jin Yang
- Department of Gynecology, The International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai 200030, China; Department of Gynecology, Shanghai Xuhui Maternity & Infant Health Hospital, Shanghai 200030, China
| | - Dan Wu
- Department of Gynecology, The International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai 200030, China.
| | - Zhunan Li
- Department of Gynecology, The International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai 200030, China
| | - Jiahao Wu
- Department of Gynecology, The International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai 200030, China
| | - Li Ding
- Department of Gynecology, The International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai 200030, China
| | - Ying Xu
- Department of Gynecology, The International Peace Maternity & Child Health Hospital of China Welfare Institute, Shanghai 200030, China
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Christian T, Guell C. Knowledge and Attitudes of Cervical Cancer Screening Among Caribbean Women: A Qualitative Interview Study From Barbados. Women Health 2015; 55:566-79. [PMID: 25833319 DOI: 10.1080/03630242.2015.1022816] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to explore Barbadian women's attitudes toward and knowledge of routine cervical cancer screening (Pap tests). We conducted semi-structured individual interviews with fourteen female patients between the ages of 20 and 60 years who attended a selected public clinic in Barbados in May and June 2013. Interviews were audio-recorded with participants' consent. The interviews were then transcribed verbatim and, using thematic content analysis, indexed and coded inductively for emerging similar themes. We identified four themes: (1) women had poor knowledge of the purpose of Pap tests. The most frequently occurring misconception was that the test was for the detection of sexually transmitted infections. (2) The women displayed limited cervical cancer awareness. (3) Health professionals were identified by the women as the main driving force behind women taking up screening. (4) The screening procedure was perceived as painful, but women's overriding attitude was that screening was necessary. These findings suggest that Barbadian women would benefit from focused health education efforts surrounding cervical cancer screening to eradicate the misconception that the purpose of the Pap test is the detection of sexually transmitted diseases.
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Affiliation(s)
- Trudy Christian
- a Public Health Group, Faculty of Medical Sciences , University of the West Indies , Cave Hill Campus, Bridgetown , Barbados
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Nahvijou A, Hadji M, BaratiMarnani A, Tourang F, NedaBayat N, Weiderpass E, Daroudi R, AkbariSari A, Zendehdel K. A Systematic Review of Economic Aspects of Cervical Cancer Screening Strategies Worldwide: Discrepancy between Economic Analysis and Policymaking. Asian Pac J Cancer Prev 2014. [DOI: 10.7314/apjcp.2014.15.19.8229] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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10
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Zhang R, He YF, Chen M, Chen CM, Zhu QJ, Lu H, Wei ZH, Li F, Zhang XX, Xu CJ, Yu L. Diagnosis of 25 genotypes of human papillomaviruses for their physical statuses in cervical precancerous/cancerous lesions: a comparison of E2/E6E7 ratio-based vs. multiple E1-L1/E6E7 ratio-based detection techniques. J Transl Med 2014; 12:282. [PMID: 25269554 PMCID: PMC4192431 DOI: 10.1186/s12967-014-0282-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 09/24/2014] [Indexed: 01/15/2023] Open
Abstract
Background Cervical lesions caused by integrated human papillomavirus (HPV) infection are highly dangerous because they can quickly develop into invasive cancers. However, clinicians are currently hampered by the lack of a quick, convenient and precise technique to detect integrated/mixed infections of various genotypes of HPVs in the cervix. This study aimed to develop a practical tool to determine the physical status of different HPVs and evaluate its clinical significance. Methods The target population comprised 1162 women with an HPV infection history of > six months and an abnormal cervical cytological finding. The multiple E1-L1/E6E7 ratio analysis, a novel technique, was developed based on determining the ratios of E1/E6E7, E2/E6E7, E4E5/E6E7, L2/E6E7 and L1/E6E7 within the viral genome. Any imbalanced ratios indicate integration. Its diagnostic and predictive performances were compared with those of E2/E6E7 ratio analysis. The detection accuracy of both techniques was evaluated using the gold-standard technique “detection of integrated papillomavirus sequences” (DIPS). To realize a multigenotypic detection goal, a primer and probe library was established. Results The integration rate of a particular genotype of HPV was correlated with its tumorigenic potential and women with higher lesion grades often carried lower viral loads. The E1-L1/E6E7 ratio analysis achieved 92.7% sensitivity and 99.0% specificity in detecting HPV integration, while the E2/E6E7 ratio analysis showed a much lower sensitivity (75.6%) and a similar specificity (99.3%). Interference due to episomal copies was observed in both techniques, leading to false-negative results. However, some positive results of E1-L1/E6E7 ratio analysis were missed by DIPS due to its stochastic detection nature. The E1-L1/E6E7 ratio analysis is more efficient than E2/E6E7 ratio analysis and DIPS in predicting precancerous/cancerous lesions, in which both positive predictive values (36.7%-82.3%) and negative predictive values (75.9%-100%) were highest (based on the results of three rounds of biopsies). Conclusions The multiple E1-L1/E6E7 ratio analysis is more sensitive and predictive than E2/E6E7 ratio analysis as a triage test for detecting HPV integration. It can effectively narrow the range of candidates for colposcopic examination and cervical biopsy, thereby lowering the expense of cervical cancer prevention. Electronic supplementary material The online version of this article (doi:10.1186/s12967-014-0282-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rong Zhang
- Department of Obstetrics and Gynecology, Fengxian Hospital, Southern Medical University, 6600 Nanfeng Road, Shanghai, 201499, China.
| | - Yi-feng He
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China. .,Shanghai Key Laboratory of Gynecologic Oncology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Mo Chen
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China.
| | - Chun-mei Chen
- State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Sciences, Fudan University, 220 Handan Road, Shanghai, 200433, China.
| | - Qiu-jing Zhu
- Shanghai Key Laboratory of Gynecologic Oncology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Huan Lu
- Department of Obstetrics and Gynecology, Fengxian Hospital, Southern Medical University, 6600 Nanfeng Road, Shanghai, 201499, China.
| | - Zhen-hong Wei
- Department of Obstetrics and Gynecology, Fengxian Hospital, Southern Medical University, 6600 Nanfeng Road, Shanghai, 201499, China.
| | - Fang Li
- Department of Obstetrics and Gynecology, Fengxian Hospital, Southern Medical University, 6600 Nanfeng Road, Shanghai, 201499, China.
| | - Xiao-xin Zhang
- Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, 160 Pujian Road, Shanghai, 200127, China.
| | - Cong-jian Xu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, 419 Fangxie Road, Shanghai, 200011, China.
| | - Long Yu
- State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Sciences, Fudan University, 220 Handan Road, Shanghai, 200433, China.
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Chundarat PA, Suwannarurk K, Bhamarapravatana K, Pattaraarchachai J, Thaweekul Y, Mairaing K, Poomtavorn Y. Incidental finding of abnormal cervical pathology in hysterectomy specimens after normal preoperative Papanicolaou smears in Thammasat University Hospital. Asian Pac J Cancer Prev 2014; 15:5811-4. [PMID: 25081705 DOI: 10.7314/apjcp.2014.15.14.5811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate abnormal cervical histopathology (ACH) from hysterectomy specimens with normal preoperative Papanicolaou (Pap) smears. MATERIALS AND METHODS Medical records from May 2009 to April 2012 were retrospectively reviewed of subjects from whom hysterectomy specimens were taken in Thammasat University Hospital. All had normal preoperative Pap smears. ACH was the primary outcome. A p-value less than 0.05 was considered significant. A total of 483 subjects with an average age of 50.5 years were recruited. Benign cases of enlarged uterus and pelvic mass were present in 94% (430/483). Endometrial and ovarian cancer were found at 6.2 and 4.7%, respectively. In hysterectomy specimens there were 19 (4%) cases of ACH. Silent ACH with benign disease, endometrial and ovarian cancers were 1.2% (5/430), 33.3% (10/30) and 17.4% (4/23), respectively. The negative predictive value (NPV) and false negative rate of Pap smears were 96 and 4%, respectively. ACH in malignant cases were 27.9% (12/43) and 20% (2/10) in adequate (APS) and inadequate (IPS) Pap collection groups, respectively. ACH in benign condition were 0.68% (2/292) and 2.2% (3/138) in APS and IPS, respectively. ACH was more often found in hysterectomy specimens with indication of malignancy than benign conditions with statistical significance. One third of preoperative stage I endometrial cancer cases had cervical involvement. CONCLUSIONS Silent ACH in normal preoperative Pap smear was 4 %. Inadequate Pap smear collection is still the major problem in this study. Reducing inadequate Pap smear collection could reduce the false negative rate.
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Affiliation(s)
- Pong-anan Chundarat
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Thammasat University, Rangsit Campus, Pathum Thani, Thailand E-mail : k_suwannarurk@ yahoo.com
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He S, Wang GL, Zhu YY, Wu MH, Ji ZG, Seng J, Ji Y, Zhou JM, Chen L. Application of the CellDetect® staining technique in diagnosis of human cervical cancer. Gynecol Oncol 2014; 132:383-8. [DOI: 10.1016/j.ygyno.2013.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/07/2013] [Accepted: 12/11/2013] [Indexed: 10/25/2022]
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