RESUMO
OBJECTIVE: To evaluate partial HPV16/18 genotyping as a possible biomarker to select women attending HPV-based cervical cancer screening at higher risk to be referred to colposcopy. DESIGN: Population-based cohort study. SETTING: Organised cervical cancer screening programmes (Italy). POPULATION: Women with high-risk HPV infection (period: 2015-2019). METHODS: We analysed the association between partial HPV16/18 genotyping, cytology triage and histologically confirmed diagnosis of high-grade cervical intraepithelial neoplasia (CIN3+ ) lesions. MAIN OUTCOME MEASURES: Detection rate (DR) and positive predictive value (PPV) for histologically confirmed CIN3+ (any episode in the 2 years after baseline); sensitivity for CIN3+ and number of colposcopies needed for lesion detection. RESULTS: The study included 145 437 women screened with HPV testing by the clinically validated COBAS 4800 HPV assay (Roche). Overall, 9601 (6.6%) women were HPV+ at baseline; HPV16 and HPV18 were present in 1865 and 594 samples, respectively. The cumulative (baseline plus 1-year repeat) cytology positivity was 42.8% and high-grade cytology was significantly higher (P < 0.0001) among women with HPV16 infection at baseline (15.2%). The cumulative CIN3+ DR for women with HPV16, HPV18 and other HPV-type infections was 9.8%, 3.4% and 1.8%, respectively. CONCLUSIONS: Partial HPV16 genotyping may play a role in triage, whereas HPV18 seems to behave much more similarly to the other HPV types and does not provide additional stratification. HPV16 genotyping combined with high-grade cytology can be envisaged as a triage biomarker in cervical screening to maximise CIN3+ detection while minimising colposcopy at baseline or 1-year repeat. TWEETABLE ABSTRACT: HPV16 genotyping combined with high-grade cytology can be used as triage biomarker for CIN3+ in HPV-positive women.
Assuntos
Genótipo , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/virologia , Adulto , Idade de Início , Biomarcadores Tumorais , Colposcopia , Detecção Precoce de Câncer , Feminino , Técnicas Histológicas , Papillomavirus Humano 16/isolamento & purificação , Papillomavirus Humano 18/isolamento & purificação , Humanos , Itália/epidemiologia , Programas de Rastreamento , Pessoa de Meia-Idade , Infecções por Papillomavirus/epidemiologia , Gravidez , Fatores de Risco , Esfregaço Vaginal , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/epidemiologia , Displasia do Colo do Útero/patologia , Displasia do Colo do Útero/virologiaRESUMO
The aim of this study was to assess the validity of protein p16 expression as an indicator of progression in lesions as ASC-US and L-SIL. For this purpose, we examined 246 cytological samples (91 ASC-US, 60 L-SIL, 36 ASC-H, 59 H-SIL) of which 151 were conventional Pap-tests (CC) and 95 in liquid based cytology (LBC) with colposcopic and histology follow-up. The results showed that in the positive p16 Pap-tests a 59% PPV vs CIN2+ in all cytologic diagnoses compared to 43% in cytologic reading alone. 96% of HG cytologic lesions were positive for p16, and the data showed good correlation between positivity for p16 in the cytologic preparations and the presence of CIN2+ lesions in the histologic test (chi-square for trend p < 0.0001). The sensitivity, specificity and NPV were 93%, 52% and 91%, respectively, in all cytologic diagnostic categories. P16 was positive in 46% of ASC-US and 53% of L-SIL. The PPV vs expressed CIN2+ was higher than that observed in cytologic reading (48% vs 26%, and 31% vs 20%, respectively). The sensitivity was 83%, the specificity 67% and 54%, respectively, and the VNP was 92% and 93%. It is possible to design algorithms for colposcopic follow-up that can reduce the need to obtain a follow-up. The future application of this test may allow the creation of a bio-molecular automated pap test.
Assuntos
Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Displasia do Colo do Útero , Neoplasias do Colo do Útero , Biomarcadores/metabolismo , Inibidor p16 de Quinase Dependente de Ciclina/genética , Progressão da Doença , Feminino , Humanos , Gravidez , Reprodutibilidade dos Testes , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/patologia , Esfregaço Vaginal , Displasia do Colo do Útero/diagnóstico , Displasia do Colo do Útero/metabolismo , Displasia do Colo do Útero/patologiaRESUMO
In this research the authors had examined the possibility of showing correlation between the plates hyperaggregability tested with PAT Breddin system and ratio HDL-LDL in serum. The result is satisfactory and shows an interesting comparison.
Assuntos
Transtornos Plaquetários/sangue , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Agregação Plaquetária , Adulto , Idoso , Transtornos Plaquetários/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The objective of our research was to align to the PAT Breddin system other routine analysis. With this procedure we intend to have, further indications on eventual pre-thrombotic situations. We have passed through examination 85 subjects: 30 as negative subjects, 55 as potential positive pre-thrombotic. The 85 subjects were passed through the PAT Breddin analysis system and the biological research of the antithrombin III, the antiplasmin and the dissolution of the coagulum. The result was satisfactory, in order to allow us to verify that utilising more research parameters we will have a more complete picture of the individual thrombosis tendency.