Molecular triage of cervical screening samples in women 55–59 years of age: a pilot study

Infectious Agents and Cancer

Brief Report

Lovisa Bergengren¹  Gisela Helenius²  Gabriella Lillsunde-Larsson³ 

[1] Department of Women’s Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden;School of Health Sciences, Örebro University, Örebro, Sweden;School of Health Sciences, Örebro University, Örebro, Sweden;Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden;

关键词: Cervical screening;    Cytology;    DNA methylation;    Genotyping;    Human papillomavirus;   

DOI  :  10.1186/s13027-023-00510-1

 received in 2023-03-01, accepted in 2023-05-12,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWith HPV screening the specificity of screening positives has decreased, even with a cytological triage test. Increases in colposcopies and detection of benign or low-grade dysplasia are reported, not least in older women. These results highlight the necessity to find other triage tests in HPV screening strategies, so that women can be more accurately selected for colposcopy, thus minimizing the clinically irrelevant findings.MethodsThe study included 55- to 59-year-old women who exited the screening with normal cytology, but later in a follow-up test were positive for the HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 and had a cervical cone biopsy done. To model a screening situation with hrHPV-positive women, three different triage strategies, namely, cytology, genotyping and methylation, were performed. The study considered the effect of direct referral to colposcopy for HPV genotypes 16, 18, 31, 33, 45, 52 and 58, and methylation for FAM19A4 and hsa-mir124-2 and/or any form of abnormal cytology.ResultsSeven out of 49 women aged 55–59 years with hrHPV had a cone biopsy with high-grade squamous intraepithelial lesion. No triage method found all cases, and when comparing positive and negative predictive value and false negative rate, cytology showed better results than genotyping and methylation.ConclusionThis study does not support a switch in triage strategies from cytology to hrHPV genotyping and methylation for women above 55 years of age yet, but demonstrates the need for more evidence on molecular triage strategies.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 22