An automated quantitative <scp>DNA</scp> image cytometry system detects abnormal cells in cervical cytology with high sensitivity

Wong, Oscar Gee‐Wan; Ho, Müller; Tsun, Obe K. L.; Ng, Ah Kau; Tsui, Eva Y.; Chow, Joanne N. K.; Ip, Philip; Cheung, Annie N.Y.

doi:10.1111/cyt.12540

Cited by 8 publications

(29 citation statements)

References 37 publications

(52 reference statements)

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“…Thus, 60 articles were fully assessed, of which 45 were excluded because they failed to attend all items required by the eligibility criteria. In total, 15 studies were included in our systematic review 17‐31 (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…One study in the reference standard domain was considered to be at a high risk of bias because the index test was performed with knowledge of the reference standard results 29 . Six studies were considered to be at a high risk of bias because not all patients received solely histological diagnosis follow‐up as the reference standard 18,22,28‐31 . All 15 studies met the applicability criteria to answer the review question.…”

Section: Resultsmentioning

confidence: 99%

“…The included studies concerned a total of 39 401 samples, of which 25 788 (65.5%) were from smear cytology, 17,18,21,22,24,30 13 443 (34.1%) were from liquid‐based cytology (LBC), 19,23,25,26,28,29,31 and 170 (0.4%) were from cervical biopsy 20,27 . Sample size by study varied from 31 to 23 993.…”

Section: Resultsmentioning

confidence: 99%

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Aneuploidy detection for diagnostic and prognostic use in premalignant and malignant lesions of the uterine cervix: A systematic review

Costa

Ribeiro

Onofre

et al. 2020

Diagnostic Cytopathology

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ObjectiveTo systematically review the role of aneuploidy detection alone or in combination with other methods in cervical cancer screening and to evaluate the value of aneuploidy to predict the behavior of premalignant cervical lesions.MethodWe conducted a systematic review based on an electronic search for articles published between 2001 and 2020 across databases including MEDLINE/PubMed, Scopus, and Web of Science. Studies were subjected to data extraction, risk of bias, and narrative synthesis.ResultsA total of 15 articles were included in the review. Eight out of 15 studies (53.3%) were judged to be at a high or unclear risk of bias. From the 15 included studies, the index test to detect aneuploidy was DNA image cytometry (DNA‐ICM) in 12 studies and DNA flow cytometry (DNA‐FCM) in three studies. Nine studies also evaluated the performance of cytology and/or human papillomavirus (HPV) tests. For DNA‐ICM, sensitivity to detect cervical intraepithelial neoplasia or worse (CIN2+) varied between 59.0% and 95.9% and specificity varied between 54.1% and 100%. For DNA‐FCM, sensitivity varied between 27.3% to 96.8% and specificity was 100%. For cytological evaluation, sensitivity varied between 25.0% and 70.4% and specificity varied between 70.6% and 99.9%. For HPV detection, sensitivity varied between 39.4% and 100% and specificity varied between 23.3% and 84.3%.ConclusionDNA ploidy along with atypical cells findings in cytology and/or HPV detection revealed great value to detect CIN2+ lesions and to predict which lesions are more likely to progress to cervical cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Aneuploidy detection for diagnostic and prognostic use in premalignant and malignant lesions of the uterine cervix: A systematic review

Costa

Ribeiro

Onofre

et al. 2020

Diagnostic Cytopathology

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“…Our results indicated that combined diagnosis offered significantly higher sensitivity and that the positive-detection rate of hydroceles was significantly increased compared with either LBC or DNA-ICM alone, which was consistent with previous studies reported in the cervix. 17 In addition, in the 386 patients with negative benign serous effusion, LBC diagnosed 73 cases of malignant tumors, while DNA-ICM results produced only 21 false positives. Moreover, DNA-ICM detected 39 positive samples in 108 patients who received negative diagnoses of malignant serous effusion via LBC.…”

Section: Discussionmentioning

confidence: 99%

“…Our results indicated that combined diagnosis offered significantly higher sensitivity and that the positive-detection rate of hydroceles was significantly increased compared with either LBC or DNA-ICM alone, which was consistent with previous studies reported in the cervix. 17 In addition, in the 386 patients with negative benign serous effusion, LBC diagnosed 73 cases of . Cytopathology and DNA content analysis of a 61-year-old male patient presented with suspicious lesions in pleural effusion (A) moderate dysplasia (magnification, Â200).…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Liquid-Based Cytology and DNA Image Cytometry in the Diagnosis of Serous Effusion

Wang

et al. 2020

Technol Cancer Res Treat

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Background: Liquid-based cytology is one of the most useful methods to diagnose a patient with serous effusion, especially when malignancy is suspected. As an alternative to the use of liquid-based cytology only, the serous effusion can be further processed using the technique of DNA image cytometry, which may augment diagnostic utility. The aim of this study was to compare the diagnostic yields of liquid-based cytology, DNA image cytometry, and both in combination, regardless of serous-effusion etiology. Methods: We conducted a descriptive study on patients with serous effusions from July 2016 to June 2018. All samples were submitted for liquid-based cytology and DNA image cytometry techniques. We compared the results of cytopathological studies to the final diagnoses. Results: For a total of 798 samples, final diagnoses included 412 (51.6%) malignancies, 280 (35.1.%) inflammatory diseases, and 106 (13.3%) transudative serous effusions. Liquid-based cytology had a more sensitive diagnostic yield than DNA image cytometry did (38.8% vs 30.7%; P < .05), but the combination of both had a higher yield (43.7%; P < .05) compared with that of liquid-based cytology alone. For the 412 malignant serous effusions, diagnostic yields of liquid-based cytology and DNA image cytometry were 73.8% and 59.5%, respectively. The difference in sensitivity was significant ( P < .05). Combined liquid-based cytology + DNA image cytometry improved diagnostic yield to 83.3% ( P < .05). However, both liquid-based cytology and DNA image cytometry had low diagnostic yields for inflammatory diseases and transudative serous effusions. Conclusion: In serous effusion, liquid-based cytology’s diagnostic performance is better than that of DNA image cytometry. Application of both techniques can significantly increase diagnostic yield.

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Primary HPV testing with cytology versus cytology alone in cervical screening—A prospective randomized controlled trial with two rounds of screening in a Chinese population

Chan

Liu

Wei

et al. 2020

Intl Journal of Cancer

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We conducted a prospective randomized controlled trial with two screening rounds to evaluate the effectiveness of combining HPV testing with liquid‐based cytology (LBC) as a co‐test, compared to LBC only in cervical cancer screening of a Chinese population. First, 15,955 women aged 30–60 were randomized at a 1:1 ratio into an intervention group (Digene Hybrid Capture 2 HPV test with LBC) and a control group (LBC alone). Women in the intervention group would be referred for colposcopy and biopsy immediately if they were found to have high‐risk HPV regardless of cytology results. The detection of cervical intraepithelial neoplasia grade 2 or above (CIN2+) lesions was significantly higher in the intervention group compared to the control (0.95% vs. 0.38%, OR 2.50, 95% CI 1.65–3.88). At the subsequent round of screening approximately 36 months later, CIN2+ detection was significantly lower in the intervention group (0.08% vs. 0.35%, OR 0.23, 95% CI 0.08–0.57). Over the two rounds of screening, the total detection of CIN2+ was higher in the intervention group (1.01% vs. 0.66%, OR 1.53, 95% CI 1.09–2.19). There was a fourfold increase (10.6% vs. 2.4%, p < 0.001) in the number of colposcopies performed in the intervention arm. Adding a high‐risk HPV test to cytology for primary cervical screening led to earlier detection of clinically significant preinvasive lesions, resulting in a reduced detection of CIN2+ lesions in subsequent rounds and an increased rate of colposcopy.

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An automated quantitative DNA image cytometry system detects abnormal cells in cervical cytology with high sensitivity

Abstract: The automated imager system and HPV 16/18 genotyping can enhance the specificity of detecting HSIL+ (CIN2-3+) lesions.

Cited by 8 publications

References 37 publications

Aneuploidy detection for diagnostic and prognostic use in premalignant and malignant lesions of the uterine cervix: A systematic review

Aneuploidy detection for diagnostic and prognostic use in premalignant and malignant lesions of the uterine cervix: A systematic review

A Comparative Study of Liquid-Based Cytology and DNA Image Cytometry in the Diagnosis of Serous Effusion

Primary HPV testing with cytology versus cytology alone in cervical screening—A prospective randomized controlled trial with two rounds of screening in a Chinese population

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