Dysplasia and cervical cancer: current diagnostic possibilities
Authors:
L. Rotter 1,2; P. Rotterová 3; I. Kinkorová Luňáčková 3; J. Kašpírková 3; M. Michal 3; R. Hudeček 2
Authors‘ workplace:
Reprofit International s. r. o., Brno
1; Gynekologicko-porodnická klinika LF MU a FN, Brno, přednosta prof. MUDr. P. Ventruba, DrSc., MBA
2; Bioptická laboratoř, s. r. o., Plzeň
3
Published in:
Ceska Gynekol 2014; 79(4): 314-320
Overview
Objective:
To review current methods in the diagnosis of dysplasia and cervical cancer.
Design:
Review article.
Setting:
Reprofit International Ltd., Brno; Department of Gynecology and Obstetrics, University Hospital and Faculty of Medicine, Masaryk University, Brno; Biopticka laborator Ltd., Pilsen.
Methods and results:
Nowadays, there are non-invasive methods for more accurate and timely detection of uterine cervix lesions. Digital images of the uterine cervix can be analysed by a computer for characteristic features and colour patterns, which may enhance the objectivity of the colposcopic examination. Digital image processing technology and biomarkers detection (p16/Ki-67) are useful in liquid based cytology (LBC). At the molecular genetic level different tests are used to detect deoxy- or ribonucleic acid (DNA, RNA) of high-risk types of human papillomavirus (HR HPV). The introduction of HPV testing in screening procedures in the Czech Republic will further in-crease the sensitivity of screening. However, the most specific identification of cervical high-grade lesions appears to be an mRNA detection of oncogenes E6 and E7. The advanced method for the assessment of cervical lesion progress in HR HPV positive women is to determine the methylation of tumor supressor genes that normally prevents the cancer growth.
Conclusion:
Screening programs, inviting women to direct preventive gynecological examinations by health insurance, but also efficient utilization of available methods could lead to early detections of cervical dysplasias.
Keywords:
cervical dysplasia and cancer, SIL, colposcopy, LBC, HPV, methylation, mRNA
Sources
1. Alvarez, RD., Wright, TC. Effective cervical neoplasia detection with a novel optical detection system: a randomized trial. Gynecol Oncol, 2007, 104, 2, p. 281–289.
2. Alvarez, RD., Wright, TC. Jr. Increased detection of high-grade cervical intraepithelial neoplasia utilizing an optical detection system as an adjunct to colposcopy. Gynecol Oncol, 2007, 106, 1, p. 23–28.
3. Arbyn, M., Bergeron, C., Klinkhamer, P., et al. Liquid compared with conventional cervical cytology: a systematic review and meta-analysis. Obstet Gynecol, 2008, 111, p. 167–177.
4. Bekker-Grob, EW., de Kok, IM., Bulten, J., et al. Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis. Cancer Causes Control, 2012, 23, 8, p. 1323–1331.
5. Belinson, SE., Ledford, K., Rasool, N., et al. Cervical epithelial brightness by optical coherence tomography can determine histological grades of cervical neoplasia. J Low Genit Tract Dis, 2013, 17, 2, p. 160–166.
6. Bierkens, M., Hesselink, AT., Meijer, CJ., et al. CADM1 and MAL promoter methylation levels in hrHPV-positive cervical scrapes increase proportional to degree and duration of underlying cervical disease. Int J Cancer, 2013, 15, 133, p. 1293–1299.
7. Brown, CA., Bogers, J., Sahebali, S., et al. Role of protein biomarkers in the detection of high-grade disease in cervical cancer screening programs. J Oncol, 2012, Article ID 289315, 11 pages.
8. Cox, JT. Liquid-based cytology: evaluation of effectiveness, cost-effectiveness, and application to present practice. J Natl Compr Canc Netw, 2004, 2, 6, p. 597–611.
9. Etherington, IJ. Telecolposcopy – a feasibility study in primary care. J Telemed Telecare, 2002, 8, 2, p. 22–24.
10. Herbeck, G., Ondruš, J., Dvořák, V., Mortakis, A. Atlas kolposkopie. Praha: Maxdorf, 2011, s. 57–259.
11. Hesselink, AT., Heideman, DA., Steenbergen, RD., et al. Combined promoter methylation analysis of CADM1 and MAL: an objective triage tool for high-risk human papillomavirus DNA-positive women. Clin Cancer Res, 2011, 15, 17, 8, p. 2459–2465.
12. Hublarová, P., Hrstka, R., Rotterová, P., et al. Prediction of human papillomavirus 16 e6 gene expression and cervical intraepithelial neoplasia progression by methylation status. Int J Gynecol Cancer, 2009, 19, p. 321–325.
13. Huh, WK., Cestero, RM., Garcia, FA., et al. Optical detection of high-grade cervical intraepithelial neoplasia in vivo: results of a 604-patient study. Am J Obstet Gynecol, 2004, 190, 5, p. 1249–1257.
14. Igidbashian, S., Boveri, S., Spolti, N., et al. Self-collected human papillomavirus testing acceptability: comparison of two self-sampling modalities. J Womens Health (Larchmt), 2011, 20, p. 397–402.
15. Karnon, J., Peters, J., Platt, J., et al. Liquid-based cytology in cervical screening: an updated rapid and systematic review and economic analysis. Health Technol Assess, 2004, 8, p. 1–78.
16. Koutsky, LA., Ault, KA., Wheeler, CM., et al. Proof of Principle Study Investigators: A controlled trial of a human papillomavirus type 16 vaccine. N Engl J Med, 2002, 347, p. 1645–1651.
17. Laudadio, J. Human papillomavirus detection: testing methodologies and their clinical utility in cervical cancer screening. Adv Anat Pathol, 2013, 20, 3, p. 158–167.
18. Louwers, JA., Kocken, M., ter Harmsel, WA., et al. Digital colposcopy: ready for use? An overview of literature. BJOG, 2009, 116, 2, p. 220–229.
19. Louwers, JA., Zaal, A., Kocken, M., et al. Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions. BJOG, 2011, 118, 3, p. 309–318.
20. Lozano, R. Comparison of computer-assisted and manual screening of cervical cytology. Gynec Oncol, 2007, 104, 1, p 134–138.
21. Meijer, CJ., Berkhof, J., Castle, PE., et al. Guidelines for human papillomavirus DNA test requirements for primary cervical cancer screening in women 30 years and older. Int J Cancer, 2009, 124, 3, p. 516–520.
22. Nucci, MR., Crum, CP. Redefining early cervical neoplasia: recent progress. Adv Anat Pathol, 2007, 14, 1, p. 1–10.
23. Rotterová, P., Nenutil, R., Hanzelková, Z., et al. Exprese P16INK4A v dysplaziích a nádorech děložního čípku. Klin Onkol, 2003, 16, s. 249–251.
24. Rotterová, P., Nenutil, R., Rotter, L., et al. The detection of p16 protein in uterine cervix lesions. Čes Gynek, 2005, 70, 4, s. 295–298.
25. Saslow, D., Solomon, D., Lawson, HW., et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin, 2012, 62, 3, p. 147–172.
26. Schadel, D., Coumbos, A., Willrodt, RG., et al. The role of digital colposcopy for diagnosis of cervical lesions – A pilot study to access the value of telematics. Geburtshilfe Frauenheilkd, 2004, 64, 11, S. 1205–1212.
27. Schiffman, M., Clifford, G., Buonaguro, FM. Classification of weakly carcinogenic human papillomavirus types: addressing the limits of epidemiology at the borderline. Infect Agent Cancer, 2009 1, 4, p. 8.
28. Soutter, WP., Diakomanolis, E., Lyons, D., et al. Dynamic spectral imaging: improving colposcopy. Clin Cancer Res, 2009, 15, 5, p. 1814–1820.
29. Stafl, A. Cervicography: a new method for cervical cancer detection. Am J Obstet Gynec, 1981, 139, 7, p. 815–825.
30. Szarewski, A., Mesher, D., Cadman, L., et al. Comparison of seven tests for high-grade cervical intraepithelial neoplasia in women with abnormal smears: the Predictors 2 study. J Clin Microbiol, 2012, 50, 6, p. 1867–1873.
31. Tachezy, R., Smahelova, J., Salakova, M., et al. Human papillomavirus genotype distribution in Czech women and men with diseases etiologically linked to HPV. PLoS One, 2011, p. 6–7.
32. Troxel, DB. Trends in pathology malpractice claims. Amer J Surg Pathol, 2012, 36, 1, p. 1–5.
33. Twiggs, LB., Chakhtoura, NA., Ferris, DG., et al. Multimodal hyperspectroscopy as a triage test for cervical neoplasia: pivotal clinical trial results. Gynecol Oncol, 2013, 130, 1, p. 147–151.
34. Wade, R., Spackman, E., Corbett, M., et al. Adjunctive colposcopy technologies for examination of the uterine cervix – DySIS, LuViva Advanced Cervical Scan and Niris Imaging System: a systematic review and economic evaluation. Health Technol Assess, 2013, 17, 8, p. 1–240.
35. Webový portál Systému pro Vizualizaci Onkologických Dat (www.svod.cz).
36. Webový portál Globocan (http://www.globocan.iarc.fr).
37. Webový portál Cervix.cz (http://www.cervix.cz).
38. Yim, EK., Park., JS. Biomarkers in cervical cancer. Biomarker Insights, 2006, 2, p. 215–225.
39. Wright, PK., Marshall, J., Desai, M. Comparison of SurePath® and ThinPrep® liquid-based cervical cytology using positive predictive value, atypical predictive value and total predictive value as performance indicators. Cytopathology, 2010, 21, 6, p. 374–378.
40. Zaal, A., Louwers, JA., Berkhof, J., et al. Agreement between colposcopic impression and histological diagnosis among human papillomavirus type 16-positive women: a clinical trial using dynamic spectral imaging colposcopy. BJOG, 2012, 119, 5, p. 537–544.
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Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
2014 Issue 4
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