scholarly journals Multicentre Evaluation of Hepika Test Clinical Accuracy in Diagnosing HPV-Induced Cancer and Precancerous Lesions of the Uterine Cervix

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 619
Author(s):  
Daniela Gustinucci ◽  
Lucia Ciccocioppo ◽  
Luigi Coppola ◽  
Giovanni Negri ◽  
Gianfranco Zannoni ◽  
...  
Keyword(s):  
Uterine Cervix ◽  
Protein Complexes ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Population Based ◽  
Enzyme Linked Immunosorbent Assay ◽  
Lower Sensitivity ◽  
Adenocarcinoma In Situ ◽  
Clinical Accuracy ◽  
Grade 3

Objective: To evaluate the clinical accuracy of Hepika test to identify cancer/precancerous lesions of the uterine cervix. Materials and Methods: A multicentre retrospective study was carried out in 2018 and included 330 liquid-based cytology samples from three Italian centres of women aged 25–64 who had been tested for the human papillomavirus (HPV) and whose histology or follow-up outcome was known. Hepika is an enzyme-linked immunosorbent assay (ELISA) targeting the protein complexes E6#p53 and E7#pRb. After excluding samples without sufficient residual material, the clinical accuracy of Hepika test was evaluated in 274 samples: adenocarcinoma (ADC) (4), squamous cell carcinoma (SCC) (7), adenocarcinoma in situ (AIS) (1), cervical intraepithelial neoplasia (CIN) grade 3 (60), CIN2 (51), CIN1 (34), and negative histology (117). Association, sensitivity, and specificity for carcinoma, CIN3+ and CIN2+ are reported. Results: Positive Hepika test was associated with a high probability of carcinoma (odds ratio (DOR) = 33.68, 95% confidence interval (CI) 7.0–163.1); sensitivity was 81.8%, specificity, 88.2%. A positive Hepika test showed a weaker association with CIN3+ lesions (DOR = 3.5; 95% CI 1.75–6.99) and lower sensitivity (27.8%). Conclusion: The Hepika test was found to be an accurate biomarker for HPV-induced cervical carcinoma. Population-based prospective studies are needed to confirm the clinical usefulness of the Hepika test in the differential diagnosis of HPV-induced invasive lesions.

scholarly journals Long-Lasting Increased Risk of Human Papillomavirus–Related Carcinomas and Premalignancies After Cervical Intraepithelial Neoplasia Grade 3: A Population-Based Cohort Study

2017 ◽  
Vol 35 (22) ◽  
pp. 2542-2550 ◽  
Author(s):  
Renée M.F. Ebisch ◽  
Dominiek W.E. Rutten ◽  
Joanna IntHout ◽  
Willem J.G. Melchers ◽  
Leon F.A.G. Massuger ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Incidence Rate ◽  
Intraepithelial Neoplasia ◽  
Population Based ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Increased Risk ◽  
History Of ◽  
Grade 3 ◽  
Rate Ratios

Purpose The aim of this study was to determine the risk of human papillomavirus (HPV)–related carcinomas and premalignancies in women diagnosed with cervical intraepithelial neoplasia grade 3 (CIN3). Knowledge of this risk is important to preventing the development and progression of other HPV-related premalignancies and carcinomas, by considering prophylactic HPV vaccination and/or by paying increased attention to other HPV-related carcinomas and premalignancies when CIN3 is identified. Methods Women diagnosed with a CIN3 between 1990 and 2010 were identified from the Dutch nationwide registry of histopathology and cytopathology (PALGA) and matched with a control group of women without CIN3. Subsequently, all cases of high-risk (hr) HPV–associated high-grade lesions and carcinomas in the anogenital region and oropharynx between 1990 and 2015 were extracted. Incidence rate ratios were estimated for carcinomas and premalignancies of the vulva, vagina, anus, and oropharynx. Results A total of 178,036 women were identified: 89,018 with a previous diagnosis of CIN3 and 89,018 matched control subjects without a history of CIN3. Women with a history of CIN3 showed increased risk of HPV-related carcinomas and premalignancies, with incidence rate ratios of 3.85 (95% CI, 2.32 to 6.37) for anal cancer, 6.68 (95% CI, 3.64 to 12.25) for anal intraepithelial neoplasia grade 3, 4.97 (95% CI, 3.26 to 7.57) for vulvar cancer, 13.66 (93% CI, 9.69 to 19.25) for vulvar intraepithelial neoplasia grade 3, 86.08 (95% CI, 11.98 to 618.08) for vaginal cancer, 25.65 (95% CI, 10.50 to 62.69) for vaginal intraepithelial neoplasia grade 3, and 5.51 (95% CI, 1.22 to 24.84) for oropharyngeal cancer. This risk remained significantly increased, even after long-term follow-up of up to 20 years. Conclusion This population-based study shows a long-lasting increased risk for HPV-related carcinomas and premalignancies of the anogenital and oropharyngeal region after a CIN3 diagnosis. Studies that investigate methods to prevent this increased risk in this group of patients, such as intensified screening or vaccination, are warranted.

scholarly journals The risk of cervical cancer after cervical intraepithelial neoplasia grade 3: A population-based cohort study with 80,442 women

2020 ◽  
Vol 157 (1) ◽  
pp. 195-201
Author(s):  
Diede L. Loopik ◽  
Joanna IntHout ◽  
Renée M.F. Ebisch ◽  
Willem J.G. Melchers ◽  
Leon F.A.G. Massuger ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Population Based ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Grade 3

Identifying early cancer of the uterine cervix - a look at the precursor lesions: literature integrative review

2011 ◽  
Vol 5 (3) ◽  
pp. 812
Author(s):  
Rosana Oliveira Melo ◽  
Regina Mendonça Lopes ◽  
Rita Rocha Moreira
Keyword(s):  
Early Diagnosis ◽  
Uterine Cervix ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Service Access ◽  
Precursor Lesions ◽  
Treatment Access ◽  
Calidad De Vida ◽  
Factores De Riesgo ◽  
Las Mujeres

ABSTRACTObjective: presenting a literature review reflects on the prevention of precursor lesions for cancer of the uterine cervix. Method: this is about a literature integrative study. Were used in this review: books (6), summaries of theses (5) and thesis (1) articles (7), as well as national and international publications in terms of health print and online. These materials were read and analyzed between April 2009 and July 2010. Results: upon reading and cataloging the data were organized into analytical categories: identification of risk factors, prevention, early diagnosis and appropriate treatment, access to services, recognition of the subjectivity of women with precancerous lesions of the cervix. Conclusion: this study allowed reflection on the diagnosis and treatment of precursor lesions demonstrating the importance of a closer look at prevention in order to improve service access, dialogue with health professionals, as well as the quality of life and longevity of women with these lesions. Descriptors: nursing; women's health; cervix neoplasms prevention; cervical intraepithelial neoplasia;  early diagnosis.  RESUMOObjetivo: apresentar revisão da literatura sobre a importância do diagnóstico precoce das lesões precursoras para prevenção do câncer do colo do útero. Método: utilizou- se a pesquisa bibliográfica. Foram utilizados nesta revisão: livros (6), resumos de dissertações (5) e tese (1), artigos (7), além de publicações nacionais e internacionais da saúde nas modalidades impressa e online. Estes materiais foram lidos e analisados entre abril de 2009 a julho de 2010. Resultados: após a catalogação e leitura, os dados encontrados foram organizados em eixos analíticos: identificação dos fatores de risco, a prevenção, diagnóstico precoce e tratamento adequado, acesso aos serviços, valorização da subjetividade das mulheres com lesões precursoras de câncer do colo do útero. Conclusão: este estudo permitiu reflexões sobre o diagnóstico e a terapêutica das lesões precursoras demonstrando a relevância de um olhar atento para a prevenção na perspectiva de melhorar o acesso ao serviço, o diálogo com os profissionais de saúde, bem como, a qualidade de vida e longevidade das mulheres portadoras destas lesões.      Descritores: enfermagem; saúde da mulher; prevenção de câncer de colo uterino; neoplasia intra-epitelial cervical; diagnóstico precoce. RESUMEN Objetivo: presentar una revisión de la literatura con el objetivo reflexionar sobre la prevención de las lesiones precursoras de cáncer de cuello uterino. Método: se utilizó la búsqueda bibliográfica. Se utilizaron en esta revisión: los libros (6), resúmenes de tesis (5) y la tesis (1) artículos (7), así como publicaciones nacionales e internacionales en materia de salud y de impresión en línea. Estos materiales fueron leídos y analizados entre abril de 2009 y julio de 2010. Resultados: Al momento de la lectura y la catalogación de los datos fueron organizados en    categorías de análisis: la identificación de factores de riesgo, prevención, diagnóstico precoz y un tratamiento adecuado, el acceso a los servicios, el reconocimiento de la subjetividad de las mujeres con lesiones precancerosas del cuello uterino. Conclusión: este estudio permitió la reflexión sobre el diagnóstico y tratamiento de lesiones precursoras que demuestra la importancia de una mirada más cercana a la prevención con el fin de mejorar el acceso de servicio, el diálogo con los profesionales de la salud, así como la calidad de vida y longevidad de las mujeres con estas lesiones. Descriptores: enfermería, salud de la mujer; prevención de cáncer de cuello uterino; neoplasia intraepitelial del cuello uterino;  diagnóstico precoz.  

scholarly journals B7-H4 Expression in Precancerous Lesions of the Uterine Cervix

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Qianqian Zhang ◽  
Liju Zong ◽  
Hui Zhang ◽  
Wei Xie ◽  
Fan Yang ◽  
...  
Keyword(s):  
T Cells ◽  
Regulatory T Cells ◽  
Uterine Cervix ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Interferon Γ ◽  
Control Group ◽  
Low Grade ◽  
Chronic Cervicitis ◽  
Cervical Conization

Over 10% of patients diagnosed with cervical intraepithelial neoplasia (CIN) have no lesions detected in their cervical conization specimens. The purpose of this study was to determine the factors related to the absence of such lesions. We particularly sought to investigate whether the expression of B7-H4 in precancerous lesions and cancer of the uterine cervix plays a role in the presence or absence of residual lesions in conization specimens and whether this protein is associated with T cells (i.e., Foxp3+ regulatory T cells, CD4+, and CD8+) and interferon-γ production. Of the 807 patients with CIN treated by conization, 104 (12.9%) had no lesions in their conization specimens. Seventy-five of these patients were deemed the study group and were matched with 75 patients who did have CIN detected in their conization specimens (the control group). Immunohistochemistry and immunofluorescence staining were used to detect B7-H4, Foxp3, CD4, CD8, and interferon-γ in the 75 pairs of specimens obtained via biopsy; 20 samples were found to have chronic cervicitis, and another 20 had squamous cell carcinoma of the cervix. Menopause, the absence of human papillomavirus, low-grade histological findings, and a diagnosis of CIN1 and CIN2 on biopsy correlated with a low probability of lesions on conization specimens. B7-H4 expression was detected in 11.1% of CIN2, 46.6% of CIN3, and 70% of cervical cancer samples, but not in tissues representing chronic cervicitis or CIN1. B7-H4 expression was associated with the presence of lesions on conization specimens, increased regulatory T cells, decreased CD8+ T cells, and lower interferon-γ production. These data suggest that close follow-up and thorough reevaluation should be considered for patients diagnosed with CIN2 who are negative for B7-H4 expression on biopsy before proceeding with cervical conization.

scholarly journals The role of high-risk HPV genotyping in the detection of high-grade intraepithelial neoplasia or cancer in women with negative cytology but positivity for HPV: A hospital-based investigation in northeastern China

2019 ◽  
Author(s):  
Jing Zhang ◽  
Deyu Zhang ◽  
Zhuo Yang ◽  
Xiaobin Wang ◽  
Danbo Wang
Keyword(s):  
High Risk ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Northeastern China ◽  
Adenocarcinoma In Situ ◽  
High Grade ◽  
Detection Rates ◽  
Hpv Genotyping ◽  
Hpv Test

Abstract Background: The high-risk human papillomavirus (hrHPV) test has a higher sensitivity for the detection of cervical precancerous lesions than cytology can provide. The present study aimed to analyze the prevalence of hrHPV genotypes and evaluate the role of HPV genotyping triage in the detection of high-grade squamous intraepithelial lesions, adenocarcinoma in situ and cervical cancer (HSIL+) in women with negative cytology but hrHPV positivity. Methods: A retrospective study was performed in women who underwent co-screening at the China Medical University-affiliated Shengjing Hospital between 2012 and 2014. Results: Of the 34,587 women, 2,665 women were eligible for analysis with negative cytology and hrHPV positivity. In HSIL+ groups of 204 women, the common genotypes were HPV16, HPV52, HPV58, HPV33, HPV31 and HPV18. The detection rate of histological HSIL+ in women with HPV16 or HPV33 was significantly higher than that in patients with other hrHPV genotypes (P = 0.00, P = 0.03, respectively). The detection rates of histological HSIL+ in women infected with HPV33 or HPV31 had no significantly difference compared to women infected with HPV16 (P = 0.29, P = 0.19, respectively).The odds ratio (OR) for histological HSIL+ in women with HPV16/18/31/33 was higher than that in women with HPV16/18 (4.21 vs. 3.26). The OR for histological HSIL+ was 5.73 in women with HPV16/18/31/33/52/58. The addition of HPV31/33 genotyping to that of HPV16/18 increased the rate of HSIL+ detection from 63.2% to 77.5% (P = 0.002). Moreover, the colposcopy per HSIL+ detection ratio only increased slightly from 7.7 to 8.1. Conclusion: HPV genotyping played an important role in managing women with negative cytology but hrHPV positivity. In northeastern China, the addition of HPV31/33 genotyping to that of HPV16/18 is deemed necessary in triaging women with a positive HPV test.

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