Current non-invasive methods for diagnosing cervical intraepithelial neoplasia and their effectiveness

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

Objective: To evaluate the diagnostic characteristics of fluorescence spectroscopy using LuViva technology for diagnosing cervical intraepithelial neoplasia.

Materials and methods: This study included 156 patients. The median patient age was 32 years (Q1–Q3: 27–39 years). All patients underwent fluorescence spectroscopy and cytological examination of the cervical and cervical canal scrapings using liquid cytology. Testing for high-risk human papillomavirus (hrHPV) using real-time PCR in cervical canal discharge was performed in 138 patients (88.5%), and extended colposcopy and targeted biopsy (as indicated) were performed in 52 women.

Results: The positive predictive value of fluorescence spectroscopy for detecting cytological changes of grade ≥ASCUS was 28.7% and the negative predictive value was 88.4%. The diagnostic characteristics of the methods used were compared with those of histological examination of cervical biopsy specimens. In the presence of hrHPV (43% of patients), the odds of detecting HSIL were almost 20 times higher (odds ratio [OR]=9.96, 95% CI 1.04–384.61). The sensitivity of the cytological test for LSIL and HSIL was 35.3% and 50%, respectively, whereas the specificity was 91.4% and 93.2%, respectively. The positive predictive values of cytological examination for LSIL and HSIL were 66.7% and 57.1%, respectively, while the negative predictive values were 74.4% and 91.1%, respectively. The positive predictive values of fluorescence spectroscopy for LSIL and HSIL were 42.5% and 15%, respectively, while the negative predictive values were 100% and 83.3%, respectively.

Conclusion: Fluorescence spectroscopy has higher sensitivity than liquid cytology. The non-invasive technique of fluorescence spectroscopy can act as a triage test for patients with conflicting results of cytology and HPV testing and determines the choice between immediate colposcopy and dynamic observation.

About the authors

Armine R. Khachaturian

D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology

Author for correspondence.
Email: armine2709@mail.ru
ORCID iD: 0000-0003-2141-6307
SPIN-code: 2691-3910
Scopus Author ID: 57201737893
ResearcherId: N-3126-2015

PhD, Senior Researcher at the Department of Gynecology and Endocrinology

Russian Federation, Saint Petersburg

Maria I. Yarmolinskaya

D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology

Email: m.yarmolinskaya@gmail.com
ORCID iD: 0000-0002-6551-4147
SPIN-code: 3686-3605

Dr. Med. Sci., Professor of the RAS, Head of the Department of Gynecology and Endocrinology, Head of the Center of Diagnostics and Treatment of Endometriosis

Russian Federation, Saint Petersburg

References

  1. Koliopoulos G., Nyaga V.N., Santesso N., Bryant A., Martin-Hirsch P.P., Mustafa R.A. et al. Cytology versus HPV testing for cervical cancer screening in the general population. Cochrane Database Syst. Rev. 2017; 8(8): CD008587. https://dx.doi.org/10.1002/14651858.CD008587.pub2.
  2. Venetianer R., Clarke M.A., van der Marel J., Tota J., Schiffman M., Dunn S.T. et al. Identification of HPV genotypes causing cervical precancer using tissue-based genotyping. Int. J. Cancer. 2020; 146(10): 2836-44. https://dx.doi.org/10.1002/ijc.32919.
  3. El-Zein M., Bouten S., Abdrabo L.S., Siblini A., Louvanto K., Franco E. et al. Genotyping and cytology triage of high-risk HPV DNA positive women for detection of cervical high-grade lesions. J. Low Genit. Tract. Dis. 2023; 27(1): 12-8. https://dx.doi.org/10.1097/LGT.0000000000000706.
  4. Bonde J., Floore A., Ejegod D., Vink F.J., Hesselink A., van de Ven P.M. et al. Methylation markers FAM19A4 and miR124-2 as triage strategy for primary human papillomavirus screen positive women: A large European multicenter study. Int. J. Cancer. 2021; 148(2): 396-405. https://dx.doi.org/10.1002/ijc.33320.
  5. Cosper P.F., Bradley S., Luo L., Kimple R.J. Biology of HPV mediated carcinogenesis and tumor progression. Semin. Radiat. Oncol. 2021; 31(4): 265-73. https://dx.doi.org/10.1016/j.semradonc.2021.02.006.
  6. Olivas A.D., Barroeta J.E., Lastra R.R. Overview of ancillary techniques in cervical cytology. Acta Cytol. 2023; 67(2): 119-28. https:// dx.doi.org/10.1159/000528931.
  7. Министерство здравоохранения Российской Федерации. Клинические рекомендации. Цервикальная интраэпителиальная неоплазия, эрозия и эктропион шейки матки. 2020. [Ministry of Health of the Russian Federation. Clinical guidelines. Cervical intraepithelial neoplasia, erosion, and cervical ectropion. 2020. (in Russian)].
  8. Perkins R.B., Guido R.L., Saraiya M., Sawaya G.F., Wentzensen N., Schiffman M. et al. Summary of current guidelines for cervical cancer screening and management of abnormal test results: 2016-2020. J. Womens Health (Larchmt). 2021; 30(1): 5-13. https://dx.doi.org/10.1089/jwh.2020.8918.
  9. Сингер А. Новые оптико-электрические методики в скрининге предраковых заболеваний шейки матки. Материалы Международной научно-практической конференции «Профилактика рака шейки матки: взгляд в будущее». Москва, 31 марта-3 апреля 2008 г. М.; 2008: 130-1. [Singer A. New optical-electric techniques in cervical precancerous disease screening. Materials of the International Scientific and Practical Conference "Prevention of cervical cancer: a look into the future." Moscow, March 31-April 3, 2008. Moscow; 2008: 130-1. (in Russian)].
  10. Kendrick J.E., Huh W.K., Alvarez R.D. LUMA cervical imaging system. Expert Rev. Med. Devices. 2007; 4(2): 121-9. https://dx.doi.org/10.1586/17434440.4.2.121.
  11. Singer A., Coppleson M., Canfell K., Skladnev V., Mackellar G., Pisal N. et al. A real time optoelectronic device as an adjunct to the Pap smear for cervical screening: a multicenter evaluation. Int. J. Gynecol. Cancer. 2003; 13(6): 804-11. https://dx.doi.org/10.1111/j.1525-1438.2003.13393.x.
  12. Pruski D., Kedzia W., Przybylski M., Józefiak A., Kedzia H., Spaczyński M. Ocena przydatności metody optoelektronicznej w wykrywaniu śródnabłonkowej neoplazji szyjki macicy [Assesment of real optoelectronic method in the detection of cervical intraepithelial neoplasia]. Ginekol. Pol. 2008; 79(5): 342-6. (in Polish).
  13. Минкина Г.Н., Храмова О.К., Фириченко С.В. Клиническая эффективность оптикоэлектронной технологии TruScreen в диагностике цервикальной интраэпителиальной неоплазии. Вестник РГМУ. 2011; 4: 37-42. [Minkina G.N., Khramova O.K., Firichenko S.V. Clinical efficacy of TruScreen oprical-electronic technology in the diagnosis of cervical intraepithelial neoplasia. Bulletin of RSMU. 2011; (4): 37-42. (in Russian)].
  14. Wade R., Spackman E., Corbett M., Walker S., Light K., Naik R. 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): 1-240, v-vi. https://dx.doi.org/10.3310/hta17080.
  15. Awolude O.A., Akinwunmi B.O., Adewole I.F. Multimodal hyperspectroscopy screening in women at risk of cervical cancer: Results of a pilot study in a developing country. Trop. J. Obstet. Gynaecol. 2017; 34(2): 134-9. https://dx.doi.org/10.4103/TJOG.TJOG_31_17.
  16. Twiggs L.B., Chakhtoura N.A., Ferris D.G. Multimodal hyperspectroscopy as a triage test for cervical neoplasia: Pivotal clinical trial results. Gynecol. Oncol. 2013; 130(1): 147-51. https://dx.doi.org/10.1016/j.ygyno.2013.04.012.
  17. Патент на изобретение «Способ определения тактики ведения пациенток, которые составляют группу риска обнаружения плоскоклеточных интраэпителиальных поражений шейки матки». Хачатурян А.Р., Ярмолинская М.И. RU2751288C1, дата регистрации 12.07.2021. [Patent for the invention "Method for determining the management tactics of patients who are at risk of detecting squamous intraepithelial lesions of the cervix". Khachaturian A.R., Yarmolinskaya M.I. RU2751288C1, registration date 12.07.2021. (in Russian)].

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Distribution of HPV VCD types in the surveyed sample

Download (71KB)
Indexing metadata
3. Fig. 2. Correlation of histological findings with a positive HPV test

Download (76KB)
Indexing metadata

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies