Prognostic value of microRNA assessment in cervical epithelial cells of patients with mild dysplasia

2021 ◽  
Vol 16 (4) ◽  
pp. 66-75
Author(s):  
M. S. Knyazeva ◽  
Т. S. Prisyazhnaya ◽  
L. M. Zabegina ◽  
О. A. Smirnova ◽  
A. A. Mikhetko ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Roc Analysis ◽  
Scientific Literature ◽  
Cervical Dysplasia ◽  
Young Patients ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Epithelium ◽  
Intraepithelial Lesion ◽  
Concentration Ratios

Background. Currently, there are no reliable markers for the prognosis of the low-grade squamous intraepithelial lesion (LSIL) of the cervical epithelium. Scientific literature provides with inconsistent recommendations regarding the management of the young patients with a cytological diagnosis of LSIL. The progression of cervical dysplasia and the development of cervical cancer are associated with characteristic alterations of the microRNA expression profile.Objective: to assess the prognostic value of microRNA in LSIL. Materials and methods. Samples (cytological smears) obtained from patients diagnosed with LSIL (n = 36), but with a different course of the disease over the next 6–12 months. Analysis of miRNA expression was carried out by the method of “two-tailed” reverse transcription and subsequent PCR.Results. The expression level of miR-126, miR-21, miR-1246, miR-182 was statistically significantly different in the compared groups, but the predictive value of the analysis of individual molecules was low (AUC <0.65). Calculation of the concentration ratios of the “reciprocal” pairs of microRNAs made it possible to obtain a more effective prognostic marker. ROC analysis of such ratios (miR-126/miR-182, miR-21/miR-182, miR-1246/miR-182) yielded AUC values: 0.82–0.89, sensitivity: 0.71–0.92; specificity: 0.86.Conclusions. Analysis of a panel of microRNA marker molecules in the material of the cervical epithelium and calculation of the concentration ratios of “reciprocal” pairs is a promising method for prognosis of LSIL course. 

Low Utility in Colposcopy-directed Biopsies for Non-high Grade Cytological Abnormalities on PAP Smear

2020 ◽  
Vol 16 (1) ◽  
pp. 18-22
Author(s):  
Eronmwon E. Gbinigie ◽  
Joshua Fogel ◽  
Maggie Tetrokalashvili
Keyword(s):  
Pap Smear ◽  
Multinomial Logistic Regression ◽  
Cervical Dysplasia ◽  
Outcome Variable ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion ◽  
Cytologic Abnormalities ◽  
Cytology Screening

Background: Clinicians commonly perform colposcopy directed biopsies on patients with low grade squamous intraepithelial lesion (LSIL) on PAP cytology even when not consistent with clinical guidelines. Objective: We study the association of PAP cytology screening results with cervical intra-epithelia neoplasia (CIN) 2-3 high-grade dysplasia, as confirmed by colposcopy-directed biopsy. Methods: A retrospective study of 263 women with an abnormality on the PAP smear. Multinomial logistic regression was performed with predictors of PAP cytology screening results with the outcome variable of colposcopy-directed biopsy. Results: High grade squamous intraepithelial lesion (HSIL) had significantly increased relative risk for CIN 2-3 (RR: 9.85, 95% CI: 1.84, 52.79, p=0.008). LSIL was not significantly associated with CIN 2-3. In the comparisons of negative with CIN-1, both HSIL and LSIL were not significantly associated with a negative biopsy. Conclusion: HSIL is associated with cervical dysplasia of CIN 2-3 while LSIL is not associated with cervical dysplasia of CIN 2-3. We do not recommend routine biopsies in patients with LSIL cytologic abnormalities unless additional compelling factors exist.

scholarly journals Liquid Based Cytology for the Detection of Cervical Intraepithelial Lesion among Women in Jimma town, Ethiopia

2019 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Dysplasia ◽  
Screening Tests ◽  
Cancer Case ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Value ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology

Abstract BackgroundCervical cancer is the second leading type of female cancer in Ethiopia and screening is based on visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) has not yet been used. MethodWomen aged 21-65 years were enrolled. Liquid based cytology and VIA were done for the detection of cervical dysplasia. Logistic regression analysis were conducted to identify factors associated. Finally Cohen’s K was done to test agreement between the methods of diagnostics.ResultsFrom the total 448 participants, (296, 66%) were 35-65 years old. Four hundred nineteen (93.5 %) were screened using LBC of which, 97 (23.2%) had low grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high grade squamous intraepithelial lesion (HSIL). Among women with LSIL, 84(86.6%) women as well as all those HSIL were 35-65 years old and women aged 35-65 years old had 4.7 times higher odds of having intraepithelial lesions (P=0.00). A total of 294/448 (65.6%) women underwent VIA examination, of these 18 (6.1%) were found positive. Two hundred seventy two (60.7%) women screened using both LBC and VIA. Of this 6 (2.2%) were positive with both LBC and VIA screening tests. The level of agreement between the two methods was weak and statistically significant (kappa value=0.155, p=0.006). ConclusionPrevalence of cervical lesions is higher among older women. There is high variability in LBC and VIA results. Though more expensive and requiring equipment, using LBC where possible would increase cervical cancer case detection.

scholarly journals Liquid Based Cytology for the Detection of Cervical Intraepithelial Lesions among Women in Jimma Town, Ethiopia

2020 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Dysplasia ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Value ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Epithelial Lesions ◽  
High Cervical ◽  
Intraepithelial Lesions

Abstract Background: Cervical cancer is the second leading type of female cancer in Ethiopia. Screening is primarily conducted using visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) has not yet been used in Ethiopia.Method: Women aged 21-65 years were tested using LBC and VIA for the detection of cervical dysplasia. Logistic regression analysis was conducted to identify associated factors. Cohen’s K test was conducted to test agreement between LBC and VIA. Results: Forty-two percent (n=188) of 448 participants were 31 to 40 years of age and only two participants were above 60. Of the 448 participants, 419 (93.5%) were tested with LBC, 294 (65.6%) VIA and 272 (60.7%) with both LBC and VIA. Among women screened using LBC, 305(72.8%) were negative for intraepithelial lesion or malignancy (NILM), 97 (23.2%) had low grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) high grade squamous intraepithelial lesion (HSIL). Presence of cervical lesions was generally lower in younger and older aged women. Majority, 39(40%) with LSIL and 10 (59%) of women with HSIL were 41-50 years old. Women aged 51-60 years were more likely to have abnormal intraepithelial lesions compared to women aged 21-30 (AOR= 20.9,95%CI=[7.2-60.9], p=0.00). Out of 47 (10.8%) HIV-patients,14(32.56%) had intraepithelial lesion of which 10(23.3%) and 4(9.3%) had LSIL and HSIL, respectively. Among women screened with VIA, 18 (6.1%) were positive. Among the 272 (60.7%) women screened using both LBC and VIA, 6 (2.2%) were positive on both LBC and VIA. The level of agreement between the two tests was weak and statistically significant (kappa value=0.155, p=0.006). Conclusion: LBC detected high cervical squamous intra-epithelial lesions in our setting. VIA was a less reliable predictor of cervical squamous intra-epithelial lesions than LBC. Evaluating diagnostic accuracy of both LBC and VIA against histological endpoint should be completed before adopting either screening modalities.

scholarly journals Liquid-based Cytology for the Detection of Cervical Intraepithelial Lesions in Jimma Town, Ethiopia

2020 ◽  
Author(s):  
Getnet Tesfaw ◽  
Yesuf Ahmed ◽  
Lealem Gedefaw ◽  
Lamessa Dube ◽  
Samson Godu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cervical Dysplasia ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Kappa Test ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Epithelial Lesions ◽  
Intraepithelial Lesions

Abstract Background: Cervical cancer is the second leading type of female cancer in Ethiopia. Screening for cervical cancer is primarily conducted using visual inspection with 5% acetic acid (VIA). Liquid-based cytology (LBC) is not yet widely used in Ethiopia. Method: Women aged 21-65 years were tested using LBC and VIA to detect cervical dysplasia. Logistic regression analysis was conducted to identify associated factors. Cohen’s Kappa test was conducted to test agreement between LBC and VIA. Results: Forty-two percent (n=188) of 448 participants were 31 to 40 years of age and only two participants were above 60. Of the 448 participants, 419 (93.5%) were tested with LBC, 294 (65.6%) VIA and 272 (60.7%) with both LBC and VIA. Among women screened using LBC, 305 (72.8%) were negative for intraepithelial lesion or malignancy (NILM), 97 (23.2%) had low-grade squamous intraepithelial lesion (LSIL) and 17 (4.1%) had high-grade squamous intraepithelial lesion (HSIL). Presence of cervical lesions was generally lower in younger and older women. Majority, 39 (40%) of women with LSIL and 10 (59%) with HSIL were 41-50 years of age. Women aged 51-60 were more likely to have abnormal intraepithelial lesions compared to women aged 21-30 (AOR= 20.9, 95% CI=[7.2-60.9], p=0.00). Out of 47 (10.8%) HIV-positive women, 14 (32.56%) had intraepithelial lesions of which 10 (23.3%) and 4 (9.3%) had LSIL and HSIL, respectively. Among women screened with VIA, 18 (6.1%) were positive; among the 272 (60.7%) women screened using both LBC and VIA, 6 (2.2%) were positive on both LBC and VIA tests. The level of agreement between the two tests was weak at a statistically significant level (kappa value=0.155, p=0.006). Conclusion: LBC demonstrated high rates of cervical squamous intra-epithelial lesions in our study. VIA was a less reliable predictor of cervical squamous intra-epithelial lesions than LBC. Evaluating diagnostic accuracy of both LBC and VIA against a histological endpoint should be completed before adopting either or both screening modalities.

scholarly journals Comparing the Performance of Hybrid Capture II and Polymerase Chain Reaction (PCR) for the Identification of Cervical Dysplasia in the Screening and Diagnostic Settings

2013 ◽  
Vol 7 ◽  
pp. CMO.S12811 ◽  
Author(s):  
Hung N. Luu ◽  
Karen Adler-Storthz ◽  
Laura M. Dillon ◽  
Michele Follen ◽  
Michael E. Scheurer
Keyword(s):  
Predictive Value ◽  
Cervical Dysplasia ◽  
The United States ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Hybrid Capture ◽  
Intraepithelial Lesion ◽  
Polymerase Chain ◽  
Sensitivity Specificity ◽  
Positive Results

Objective Both PCR and Hybrid Capture II (HCII) have been used for identifying cervical dysplasia; however, comparisons on the performance between these two tests show inconsistent results. We evaluated the performance of HCII and PCR MY09/11 in both screening and diagnostic populations in sub-sample of 1,675 non-pregnant women from a cohort in three clinical centers in the United States and Canada. Methods Sensitivity, specificity, positive predictive value, negative predictive value, and concordance between the two tests were calculated. Results Specificity of HCII in detecting low-grade squamous intraepithelial lesion (LSIL) was higher in the screening group (88.7%; 95% CI: 86.2%–90.8%) compared to the diagnostic group (46.3%; 95% CI: 42.1%–50.6%); however, specificity of PCR was low in both the screening (32.8%; 95% CI: 29.6%–36.2%) and diagnostic (14.4%; 95% CI: 11.6%–17.6%) groups. There was comparable sensitivity by both tests in both groups to detect high-grade squamous intraepithelial lesion (HSIL); however, HCII was more specific (89.1%; 95% CI: 86.8%–91.0%; 66.2%; 95% CI: 62.0%–70.1%) than PCR (33.3%; 95% CI: 30.2%–36.5%; 17.9%; 95% CI: 14.8%–21.6%) in the screening and diagnostic groups, respectively. Overall agreement for HPV positivity was approximately 50% between HCII and PCR MY09/11; with more positive results coming from the PCR MY09/11. Conclusion In the current study, PCR MY09/11 was more sensitive but less specific than HCII in detecting LSIL, and HCII was more sensitive and specific in detecting HSIL than PCR in both screening and diagnostic groups.

scholarly journals Clinical application of the 2011 IFCPC colposcope terminology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bei Zhang ◽  
Shuhui Hong ◽  
Guihui Zhang ◽  
Fengnian Rong
Keyword(s):  
Diagnostic Accuracy ◽  
Precancerous Lesions ◽  
High Specificity ◽  
Diagnostic Value ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Diagnostic Significance ◽  
Cervical Precancerous Lesions ◽  
Intraepithelial Lesion ◽  
Common Sign

Abstract Background Colposcopy offers an accurate way to the diagnose of cervical precancerous lesions. However, the diagnostic accuracy of colposcopy is unsatisfied. This study was to evaluate colposcopic accuracy according to the 2011 International Federation of Cervical Pathology and Colposcopy (IFCPC) terminology. Methods A retrospective cohort study was performed in 1,838 patients who underwent colposcopy in Shandong Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University from October 2013 to April 2018. Using conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated, and correlations between variables were analyzed. Results As an authoritative and widely used terminology for colposcopy diagnosis, the 2011 IFCPC terminology has certain clinical practicality and diagnostic accuracy. However, some signs such as mosaic, punctation, sharp border, inner border sign and ridge sign had high specificity but unsatisfactory sensitivity, which limited the diagnostic value. Therefore, we discussed the Lugol’s staining, a very common sign in colposcopy, and analyzed the diagnostic significance of bright yellow staining in low-grade squamous intraepithelial lesion (LSIL) and mustard yellow staining in high-grade squamous intraepithelial lesion (HSIL). The results showed that mustard yellow may be a valuable indicator in the diagnosis of HSIL. Conclusion The 2011 IFCPC colposcope terminology has standardized interpretations of the colposcopic findings and improved the accuracy of colposcopy diagnosis. The aceto-white epithelium still has important diagnostic value; however, the value of a few signs is needed to be discussed and new signs are expected to be discovered. Although the significance of Lugol’s staining was diminishing, mustard yellow might be a valuable indicator for the diagnosis of HSIL.

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