A comparison of four screening methods for cervical neoplasia

Wu, Sufang; Li, Meng; Wang, ShiXuan; Ma, Ding

doi:10.1016/j.ijgo.2005.08.013

Cited by 20 publications

(14 citation statements)

References 22 publications

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“…1,[3][4][5][6] The addition of DSI to conventional colposcopy therefore results in an almost 50% increase in sensitivity; from 55% to 79% by DSI colposcopy alone if all preconditions for a optimal examination are met, and to 80% in combination with conventional colposcopy regardless of the circumstances or individual user adequacy. Hence, the higher sensitivity of DSI colposcopy alone or in combination with conventional colposcopy improves the detection of high-grade cervical lesions significantly and guides cervical sampling.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The variation in the reported performance for colposcopy is high, with the average sensitivity of colposcopy to distinguish low-from high-grade lesions and cancer being around 55%. 1,[3][4][5][6] Furthermore, the low to average sensitivity and specificity of colposcopic examination is also associated with a high degree of inter-and intra-observer variability.…”

Section: Introductionmentioning

confidence: 99%

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Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions

Louwers

Zaal

Kocken

et al. 2010

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Objective To validate the dynamic spectral imaging (DSI) colposcope's colour-coded map in discriminating high-from low-grade cervical lesions and non-neoplastic tissue.Design Prospective, comparative, multicentre clinical trial.Setting The colposcopy clinics of three Dutch hospitals.Population Women of 18 years or over with an intact cervix, referred for colposcopy.Methods During a 3-minute image acquisition phase, the DSI colposcope was used as a regular video colposcope: the colposcopist located and graded potential lesions based on conventional colposcopic criteria. Subsequently, a colour-coded map was calculated and displayed, representing localisation and severity of the cervical lesion. Biopsies were collected from all atypical sites, as identified by digital mapping and/or conventional colposcopy. Furthermore, one additional biopsy was taken. Main outcome measures Histologically confirmed high-grade cervical disease (CIN2+).Results In total 275 women were included in the study: 183 women were analysed in the 'according-to-protocol' (ATP) cohort and 239 women in the 'intention-to-treat' (ITT) cohort. In the ATP cohort, the sensitivity of DSI colposcopy to identify women with high-grade (CIN2+) lesions was 79% (95% CI 70-88) and the sensitivity of conventional colposcopy was 55% (95% CI 44-65) (P = 0.0006, asymptotic McNemar test). When the DSI colour-coded map was combined with conventional colposcopy, the sensitivity was 88% (95% CI 82-95).Conclusions DSI colposcopy has a significantly higher sensitivity to detect cervical lesions than conventional colposcopy. If the colour-coded map is combined with conventional colposcopic examination, the sensitivity increases further.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions

Louwers

Zaal

Kocken

et al. 2010

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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“…Therefore, while the incidence of CIN2 ϩ was Ͼ40% in the 2316 patients whose data were used to calculate the NPV, this is much higher than the previously reported rate of 8%. [32][33][34] This would explain the low NPV of HPV testing to detect CIN2 ϩ (ie, 82.4%). Furthermore, the results of this study may be more applicable to high-risk women undergoing consultation rather than primary cervical screenings.…”

Section: Discussionmentioning

confidence: 99%

Detection of TERC Amplification in Cervical Epithelial Cells for the Diagnosis of High-Grade Cervical Lesions and Invasive Cancer

Jiang

Wei

et al. 2010

The Journal of Molecular Diagnostics

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Because the activation of telomerase is a relatively early event in the progression of cervical carcinogenesis , the expression of the human telomerase RNA gene , TERC, has the potential to serve as a biomarker for both the diagnosis and prognosis of cervical neoplasias. In total , 83 research centers participated in the study , and 7786 patients were enrolled. TERC amplification was detected using a dual-color fluorescence in situ hybridization (FISH) probe set, and these results were compared with cytological and histological results , testing for high-risk human papillomavirus (HPV) DNA (n ‫؍‬ 2316 for the HPV DNA test), as well as patient age. TERC amplification was found to be increased in more advanced cases of cervical carcinogenesis. Moreover , a Youden's index value and the area under the receiver operating characteristic (ROC) curve were also calculated for samples with TERC amplification and found to be higher than the same values calculated for both cytology and highrisk HPV analyses of the same samples. With regard to cytological ASCUS and LSIL findings , the combination of HPV ؉ TERC testing showed the potential to provide effective triaging to detect CIN2 ؉ . Therefore, TERC amplification represents a valuable genetic biomarker , which in combination with an evaluation of cytology or HPV testing , can achieve higher sensitivity and specificity in distinguishing high-grade cervi- Cervical cancer is the second most common cancer in women, and in 2005, more than 250,000 deaths worldwide were the result of cervical cancer.1 Because ϳ80% of all cervical cancer cases are diagnosed in developing countries, in China, there are ϳ135,000 new cases and 50,000 deaths each year due to this disease.2 Without improvements in the treatments available, the number of cases of cervical cancer are projected to rise by almost 25% over the next 10 years. Therefore, to decrease the incidence and mortality associated with cervical cancer, effective approaches are needed to facilitate the screening and diagnosis of cervical precancerous lesions, especially high-grade lesions.The use of cervical cytopathologic examinations has reduced the incidence of cervical cancer in many countries, 3,4 however the low sensitivity and high variability of this method has limited its significance. 5 With human papillomavirus (HPV) being the main cause of cervical cancer, detection of HPV DNA has become an important supplement to cytologic evaluations performed during cervical cancer screenings.6,7 However, most women who are infected with HPV eliminate the virus and do not progress to high-grade disorders, thereby decreasing the specificity of HPV DNA tests for the detection of cervical cancer. 8 The infection and integration of HPV into epithelial cells are key steps in the induction of malignant alterations in cervical cancer; however, there are additional genomic events that also occur.9 One of the events associated with cervical cancer is an increase in copy number of the long arm of chromosome 3 (3q).

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“…Данная система отображения производит независимое от исследователя, количественное измерение и отображение эффектов ук-сусной кислоты. Это гарантирует значительное улучше-ние диагностики различия между цервикальной интра-эпителиальной неоплазией высокой степени и пораже-ний с низкой степенью злокачественности или в ее отсут-ствие, что было рассмотрено и изучено в работах ведущих специалистов данного направления [3,[18][19][20].…”

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“…По результа-там исследования получено заключение: DуSIS-картирование является более чувствительным, чем рас-ширенная КС, в обнаружении выраженных изменений (79% в сравнении с 49%). Кроме того, при использовании DySIS-картирования увеличивается чувствительность до 77% в выявлении высоковыраженных поражений шейки матки, особенно у пациенток с LSIL по результатам цито-логии против 19% при применении традиционной КС [19] (рис. 4).…”

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Dynamic spectral imaging: Innovative opportunities in colposcopy

Krasnopolsky¹,

Zarochentseva²,

Dzhidzhikhia³

et al. 2016

Ross. vestn. akush.-ginekol.

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A comparison of four screening methods for cervical neoplasia

Abstract: Visual inspection and colposcopy should not be used when screening for early stage cervical lesions. The DNA hybridization assay is the best choice in primary screening, if available. Screening should begin at the age of 20 years.

Cited by 20 publications

References 22 publications

Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions

Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions

Detection of TERC Amplification in Cervical Epithelial Cells for the Diagnosis of High-Grade Cervical Lesions and Invasive Cancer

Dynamic spectral imaging: Innovative opportunities in colposcopy

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