Usefulness of biomarkers in the triage of HPV positive women with normal cytology

Spruijt, A. (Annika) (2015) Usefulness of biomarkers in the triage of HPV positive women with normal cytology. thesis, Medicine.

Text SpruijtA.pdf Restricted to Registered users only Download (773kB)

Abstract

The evolution in cervical cancer screening programs, from the classical Pap test to high risk human papillomavirus (hrHPV) testing by molecular methods, much more sensitive than the first one, raises new clinical scenarios. In the new screening algorithms, cytology has been proposed to triage women who test positive for hrHPV. If any abnormality is detected in the Pap test, women are referred to colposcopy. However, those with normal cytology are not directly referred for colposcopy. Within this group, it is important to triage the subset of patients at higher risk of underlying high grade squamous intraepithelial lesion or carcinoma (HSIL+) who would benefit from an immediate colposcopy. Different biomarkers have been proposed as possible candidates for the triage of those patients. The present study analysed the sensitivity, specificity and predictive value of two biomarkers, p16/Ki-67 dual staining and genotyping for HPV16 and 18, for the detection of underlying HSIL+. Data was collected from women referred to the colposcopy clinic of the Department of Obstetrics and Gynaecology of the Hospital Clínic of Barcelona from 2009 to 2014. All women underwent liquid based cytology, hrHPV testing by the HybridCapture2 test and colposcopy with biopsy if necessary. Women testing positive for hrHPV and having a normal Pap test after the first visit were included in the study (n=264). Liquid based cytology of these women was used to perform p16/Ki-67 dual staining and HPV genotyping. p16/Ki-67 dual staining showed higher sensitivity and specificity compared to HPV16 and 18 genotyping (44.4% and 88.7% versus 37.5% and 76.5% respectively). The high specificity of dual staining suggests that this test could be useful as second step in the screening program for the triage of women having a hrHPV infection. Larger studies are warranted to confirm these preliminary results.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty mentor: and Nijholt, Dr. I.M.
Supervisor name:	Daily mentor: and Pino, Dr. M. del and Study performed at: and Hospital Clínic de Barcelona, Department of pathological ana
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 11:07
Last Modified:	25 Jun 2020 11:07
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/2723

Actions (login required)

View Item