scholarly journals Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil

2018 ◽  
Vol 40 (06) ◽  
pp. 360-368 ◽  
Author(s):  
Luiz Zeferino ◽  
Joana Bastos ◽  
Diama Vale ◽  
Rita Zanine ◽  
Yara Melo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Intraepithelial Neoplasia ◽  
Cervical Cancer Screening ◽  
Residual Disease ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
Hpv Dna ◽  
Published Evidence ◽  
Hpv Dna Tests

AbstractEvidence-based clinical guidelines ensure best practice protocols are available in health care. There is a widespread use of human papillomavirus deoxyribonucleic acid (HPV-DNA) tests in Brazil, regardless of the lack of official guidelines. On behalf of the Brazilian Association for the Lower Genital Tract Pathology and Colposcopy (ABPTGIC, in the Portuguese acronym), a team of reviewers searched for published evidence and developed a set of recommendations for the use of HPV-DNA tests in cervical cancer screening in Brazil. The product of this process was debated and consensus was sought by the participants. One concern of the authors was the inclusion of these tests in the assessment of women with cytologic atypia and women treated for cervical intraepithelial neoplasia (CIN). Testing for HPV is recommended in an organized screening scenario to identify women with precursor lesions or asymptomatic cervical cancer older than 30 years of age, and it can be performed every 5 years. It also has value after the cytology showing atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSILs) as a triage test for colposcopy, in the investigation of other cytological alterations when no abnormal findings are observed at colposcopy, seeking to exclude disease, or, further, after treatment of high-grade cervical intraepithelial neoplasia, to rule out residual disease.

Real time quantitative methylation detection of PAX1 gene in cervical cancer screening

2020 ◽  
Vol 30 (10) ◽  
pp. 1488-1492
Author(s):  
Haifeng Liu ◽  
Xia Meng ◽  
Jingyi Wang
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Intraepithelial Neoplasia ◽  
Real Time ◽  
Cervical Cancer Screening ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Cancer Group ◽  
Polymerase Chain ◽  
Folic Acid Receptor

IntroductionDNA methylation is currently found to be associated with the progression of cervical intraepithelial neoplasia and the development of cervical cancer. The aim of this study was to analyze the role of real time quantitative methylation detection of the PAX1 gene in cervical cancer screening.MethodsAll eligible patients who underwent multiple detections for cervical cancer were assigned to the normal cervical group (n=21), cervical intraepithelial neoplasia I group (n=7), cervical intraepithelial neoplasia II+III group (n=12), or invasive cervical cancer group (n=14) based on pathological gradings. The methylation level of the PAX1 gene was detected using the real time quantitative methylation specific polymerase chain reaction assay and assessed by △Cp value. The diagnostic performance of PAX1 methylation detection was compared with folic acid receptor mediated diagnosis, the Thinprep cytology test, and human papilloma virus (HPV) testing.ResultsThe △Cp value in the invasive cervical cancer group was (6.15±4.07), significantly lower than that in the other groups (F=26.45, p<0.001). The area under the curve (AUC) of PAX1 methylation detection was 0.902 (95% confidence interval (CI) 0.817–0.986; p<0.001), and sensitivity and specificity were 92.30% and 78.60% when the cut-off value of △Cp was 13.28. The AUC of PAX1 methylation detection was notably larger compared with 0.709 for folic acid receptor mediated diagnosis (95% CI 0.568–0.849, p=0.009), 0.702 for the Thinprep cytology test (95% CI 0.559–0.844, p=0.015), and 0.655 for HPV testing (95% CI 0.508–0.802, p=0.014).ConclusionThrough quantitative methylation specific polymerase chain reaction assay characterized by rapid screening and simple operation, the methylation detection of the PAX1 gene exhibited a higher diagnostic performance and may be a promising method for cervical cancer screening.

Human Telomerase RNA Gene Amplification Detection Increases the Specificity of Cervical Intraepithelial Neoplasia Screening

2010 ◽  
Vol 20 (6) ◽  
pp. 912-917 ◽  
Author(s):  
Lei Zheng ◽  
Ai-Lan Liu ◽  
Tao Qi ◽  
Qian Wang ◽  
Zhen Cai ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Intraepithelial Neoplasia ◽  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Cin Iii ◽  
Histopathologic Evaluation ◽  
Human Telomerase

Objectives:The purpose of this study was to evaluate the clinical significance of genomic amplification of the human telomerase RNA gene (TERC) for cervical cancer screening and explore whether it can serve as a biomarker to improve the specificity of human papillomavirus (HPV) DNA testing for cervical cancer screening.Methods:One hundred twenty women, including 20 cases of normal (control), 14 cases of cervical intraepithelial neoplasia grade I (CIN I), 35 cases of CIN II, 36 cases of CIN III, and 15 cases of squamous cervical cancer diagnosed by histopathologic evaluation, were subjected to cytopathologic examination, TERC detection by fluorescence in situ hybridization (FISH), and HPV DNA testing by Hybrid Capture II.Results:TERC amplification was significantly associated with cytopathologic diagnosis (P < 0.001) and histopathologic evaluation (P < 0.001). The positive rate of TERC gain was significantly higher in patients with CIN III or squamous cervical cancer than in patients with CIN I or those in the control group (P < 0.001). The specificity and positive predictive value of FISH for detecting CIN II or more severe cervical lesions (≥CIN II) were obviously higher than those of HPV DNA testing (97.1% vs 52.9%, 98.7% vs 83.8%).Conclusions:TERC amplification analyzed by FISH may serve as an adjunctive test to HPV DNA testing for improving the specificity and positive predictive value of cervical cancer screening.

scholarly journals Evaluation of DNA extraction protocols from liquid-based cytology specimens for studying cervical microbiota

2020 ◽  
Author(s):  
Takeo Shibata ◽  
Mayumi Nakagawa ◽  
Hannah N. Coleman ◽  
Sarah M. Owens ◽  
William W. Greenfield ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Intraepithelial Neoplasia ◽  
Dna Extraction ◽  
Cervical Cancer Screening ◽  
Intraepithelial Neoplasia ◽  
Extraction Protocol ◽  
Hpv Genotyping ◽  
Liquid Based Cytology

AbstractBackgroundCervical microbiota (CM) are considered an important factor affecting the progression of cervical intraepithelial neoplasia (CIN) and are implicated in the persistence of human papillomavirus (HPV). Collection of liquid-based cytology (LBC) samples is routine for cervical cancer screening and HPV genotyping, and can be used for long-term cytological biobanking. Herein, we investigate the feasibility of leveraging LBC specimens for use in CM surveys by amplicon sequencing. As methodological differences in DNA extraction protocols can potentially bias the composition of microbiota, we set out to determine the performance of four commonly used DNA extraction kits (ZymoBIOMICS DNA Miniprep Kit; QIAamp PowerFecal Pro DNA Kit; QIAamp DNA Mini Kit; and IndiSpin Pathogen Kit) and their ability to capture the diversity of CM from LBC specimens.ResultsLBC specimens from 20 patients (stored for 716 ± 105 days) with cervical intraepithelial neoplasia (CIN) 2/3 or suspected CIN2/3 were each aliquoted for the four kits. We observed that, regardless of the extraction protocol used, all kits provided equivalent accessibility to the cervical microbiome, with some minor differences. For example, the ZymoBIOMICS kit appeared to differentially increase access of several microbiota compared to the other kits. Potential kit contaminants were observed as well. Approximately 80% microbial genera were shared among all DNA extraction protocols. The variance of microbial composition per individual was larger than that of the DNA extraction protocol used. We also observed that HPV16 infection was significantly associated with community types that were not dominated by Lactobacillus iners.ConclusionsCollection of LBC specimens is routine for cervical cancer screening and HPV genotyping, and can be used for long-term cytological biobanking. We demonstrated that LBC samples, which had been under prolonged storage prior to DNA extraction, were able to provide a robust assessment of the CM and its relationship to HPV status, regardless of the extraction kit used. Being able to retroactively access the CM from biobanked LBC samples, will allow researchers to better interrogate historical interactions between the CM and its relationship to CIN and HPV. This alone has the potential to bring CM research one-step closer to the clinical practice.

scholarly journals The Vaginal Microbiome and Cervical Cancer Screening in Low- and Middle-Income Countries

2019 ◽  
Vol 5 (Supplement_1) ◽  
pp. 6-6
Author(s):  
Supriya D. Mehta
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Intraepithelial Neoplasia ◽  
Cervical Cancer Screening ◽  
Intraepithelial Neoplasia ◽  
Vaginal Microbiome ◽  
Middle Income ◽  
Middle Income Countries ◽  
Cancer Pathogenesis ◽  
Low And Middle Income

PURPOSE Globally, cervical cancer affects more than a half-million women each year, with disproportionate incidence and mortality for women in low- and middle-income countries. Early detection through cervical cancer screening saves lives but is hampered by poor coverage, suboptimal detection accuracy, and lack of access to and delays in effective treatment. METHODS Emerging evidence that indicates how the vaginal microbiome can modify progression of human papillomavirus (HPV) infection and cervical cancer pathogenesis is surveyed. This presentation features a discussion of how the vaginal microbiome may affect cervical cancer screening and how cervical cancer screening may incorporate vaginal microbiome health in low- and middle-income countries. RESULTS Vaginal dysbiosis as a clinical syndrome may be called bacterial vaginosis (BV), a condition that represents a shift from a Lactobacillus-dominant vaginal microbiome to one that is polymicrobial and often associated with increased mucosal inflammation. Meta-analyses and prospective studies demonstrate an association between vaginal dysbiosis and increased risk of HPV incidence and persistence and high-grade lesions and cancer. Increasing vaginal microbiome diversity is associated with progression of cervical intraepithelial neoplasia. Vaginal microbiota that are associated with greater likelihood of HPV detection in molecular studies are also commonly associated with BV. There are numerous challenges to incorporating microbiome measurement in population-level cervical cancer screening and unanswered research questions on its immediate utility. BV may serve as a measure of vaginal microbiome health, although there are no guidelines or recommendations for regular BV screening and treatment. CONCLUSION Ongoing and planned longitudinal studies should evaluate BV screening in association with high-risk HPV, results of cervical cancer screening, and progression of cervical intraepithelial neoplasia to assess the utility of BV screening and treatment as an adjunct to cervical cancer screening and potential intervention.

scholarly journals Co-infection with trichomonas vaginalis increases the risk of cervical intraepithelial neoplasia grade 2-3 among HPV16 positive female: a large population-based study.

2020 ◽  
Author(s):  
Mei Yang ◽  
Lin Li ◽  
Chunfan Jiang ◽  
Xiaomin Qin ◽  
Min Zhou ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Intraepithelial Neoplasia ◽  
Cervical Cancer Screening ◽  
Large Population ◽  
Intraepithelial Neoplasia ◽  
Central China ◽  
Cervical Lesions ◽  
Hpv 16 ◽  
Hpv 18

Abstract Background: Evidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV. This study aimed at evaluating the influence of common vaginal infection on the carcinogenicity of hr-HPV. Methods: From January 15, 2017 to December 31, 2017, 310,545 female aged at least 30 years old had been recruited for cervical cancer screening from 9 clinical research centers in Central China. All the recruited participants received hr-HPV genotyping for cervical cancer screening and vaginal microenvironment test by a high vaginal swab. Colposcopy-directed biopsy was recommended for female who were infected with HPV 16 and HPV 18, and other positive hr-HPV types through test had undertaken triage using liquid-based cytology, cases with the results ≥ ASCUS among them were referred to colposcopy directly, and cervical tissues were taken for pathology examination to make clear the presence or absence of other cervical lesions.Results: Among 310,545 female, 6,067 (1.95%) were tested with positive HPV 16 and HPV 18, 18,297 (5.89%) were tested with other positive hr-HPV genotypes, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and invasive cervical cancer (ICC) were detected in 861 cases, 377 cases, 423 cases, and 77 cases, respectively. Candida albicans and Gardnerella were not associated with the detection of cervical lesions. Positive trichomonas vaginitis (TV) was correlated with hr-HPV infection (p<0.0001). Co-infection with TV increased the risk of CIN 1 among female infected with hr-HPV (OR 1.18, 95% CI: 1.42-2.31). Co-infection with TV increased the risk of CIN 2-3 among female infected with HPV 16 (OR 1.71, 95% CI: 1.16-2.53).Conclusions: Co-infection of TV and HPV 16 is a significant factor for the detection of cervical lesions.

AgNOR Pleomorphic Count as a Tumor Marker in Cervical Carcinogenesis and Feasibility of Its Introduction in Cervical Cancer Screening Programs to Discriminate High-Risk Cases of Squamous Intraepithelial Lesions of the Cervix

2019 ◽  
Vol 63 (5) ◽  
pp. 371-378 ◽  
Author(s):  
Anand N. Srivastava ◽  
Jata S. Misra ◽  
Urmilla Singh ◽  
Mohsin Khan ◽  
Syed Raza
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Tumor Marker ◽  
Cervical Cancer Screening ◽  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Hpv Dna ◽  
Screening Programs ◽  
Intraepithelial Lesions

Background: AgNOR pleomorphism has been widely used for its diagnostic importance in differentiating premalignant and malignant lesions of different human neoplasms. However, an evaluation of its potential for discriminating cases of high-risk squamous intraepithelial lesions of the cervix (SIL) has been rarely attempted. Aim: The tumor marker potential of AgNOR pleomorphism counts was assessed by correlating high and low mean counts in low-grade SIL (LSIL) cases with persistence or regression of the lesion and HPV positivity. Materials and Methods: The 115 LSIL cases selected for the study were registered from the ongoing cervical cancer screening of the rural population of Lucknow West. Silver nitrate staining for AgNOR counts and HPV DNA testing were done in all 115 cases. Results: The AgNOR counts in the 115 LSIL cases revealed low counts in 92 and high counts in 23 cases. Follow-up, available in 107 cases, revealed persistence of the lesion in 21 of the 23 cases with high counts and in 4 of the 84 cases with low counts. HPV positivity showed a strong correlation with high counts. Persistence of LSIL was also more frequent with high AgNOR counts and in HPV-positive cases. Conclusions: The study showed a correlation of high mean AgNOR counts with HPV positivity and persistence of LSIL.

scholarly journals Co-infection with trichomonas vaginalis increases the risk of cervical intraepithelial neoplasia grade 2-3 among HPV16 positive female: a large population-based study.

2020 ◽  
Author(s):  
Mei Yang ◽  
Lin Li ◽  
Chunfan Jiang ◽  
Xiaomin Qin ◽  
Min Zhou ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Intraepithelial Neoplasia ◽  
Cervical Cancer Screening ◽  
Large Population ◽  
Intraepithelial Neoplasia ◽  
Central China ◽  
Cervical Lesions ◽  
Hpv 16 ◽  
Hpv 18

Abstract Background: Evidence suggested that vaginal microbiome played a functional role in the progression of cervical lesions in female infected by HPV. This study aimed at evaluating the influence of common vaginal infection on the carcinogenicity of high risk HPV (hr-HPV). Methods: From January 15, 2017 to December 31, 2017, 310,545 female aged at least 30 years old had been recruited for cervical cancer screening from 9 clinical research centers in Central China. All the recruited participants received hr-HPV genotyping for cervical cancer screening and vaginal microenvironment test by a high vaginal swab. Colposcopy-directed biopsy was recommended for female who were infected with HPV 16 and HPV 18, and other positive hr-HPV types through test had undertaken triage using liquid-based cytology, cases with the results ≥ ASCUS among them were referred to colposcopy directly, and cervical tissues were taken for pathology examination to make clear the presence or absence of other cervical lesions.Results: Among 310,545 female, 6,067 (1.95%) were tested with positive HPV 16 and HPV 18, 18,297 (5.89%) were tested with other positive hr-HPV genotypes, cervical intraepithelial neoplasia (CIN) 1, CIN 2, CIN 3 and invasive cervical cancer (ICC) were detected in 861 cases, 377 cases, 423 cases, and 77 cases, respectively. Candida albicans and Gardnerella were not associated with the detection of cervical lesions. Positive trichomonas vaginitis (TV) was correlated with hr-HPV infection (p<0.0001). Co-infection with TV increased the risk of CIN 1 among female infected with hr-HPV (OR 1.18, 95% CI: 1.42-2.31). Co-infection with TV increased the risk of CIN 2-3 among female infected with HPV 16 (OR 1.71, 95% CI: 1.16-2.53).Conclusions: Co-infection of TV and HPV 16 is a significant factor for the detection of cervical lesions.

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