Options for triage and implications for colposcopists within European HPV-based cervical screening programmes

Leeson, Simon; Alalade, Remi; Singh, Neelam; Nieminen, Pekka; Cruickshank, Margaret; Carcopino, Xavier; Bergeron, Christine

doi:10.1016/j.ejogrb.2020.12.061

Cited by 3 publications

(6 citation statements)

References 82 publications

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“…HPV typing increases the specificity of CIN2+ detection but the reported data are largely from unvaccinated populations and the benefit will probably be reduced with the rise in vaccination. 11 DNA methylation analysis has shown consistent high sensitivity for CIN, an appealing option because it can be performed on selfsamples. 11,12 However, these strategies have not yet reached routine practice and it has proven difficult to compare the clinical performance and cost effectiveness.…”

Section: Tr I Age Of Hrhpv-positi V E Te Stsmentioning

confidence: 99%

“…11 DNA methylation analysis has shown consistent high sensitivity for CIN, an appealing option because it can be performed on selfsamples. 11,12 However, these strategies have not yet reached routine practice and it has proven difficult to compare the clinical performance and cost effectiveness. It is likely that a combined method, dependent on the specifics of the national CSP would be optimal.…”

Section: Tr I Age Of Hrhpv-positi V E Te Stsmentioning

confidence: 99%

“…The use of HPV 16/18 typing and DNA methylation are attractive because self‐samples can be used and analysis can be automated. HPV typing increases the specificity of CIN2+ detection but the reported data are largely from unvaccinated populations and the benefit will probably be reduced with the rise in vaccination 11 . DNA methylation analysis has shown consistent high sensitivity for CIN, an appealing option because it can be performed on self‐samples 11,12 .…”

Section: Triage Of Hrhpv‐positive Testsmentioning

confidence: 99%

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Recent advances in the cervical screening programme

Hawco

Cruickshank

2022

BJOG

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Section: Tr I Age Of Hrhpv-positi V E Te Stsmentioning

confidence: 99%

Section: Tr I Age Of Hrhpv-positi V E Te Stsmentioning

confidence: 99%

Section: Triage Of Hrhpv‐positive Testsmentioning

confidence: 99%

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Recent advances in the cervical screening programme

Hawco

Cruickshank

2022

BJOG

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“…To avoid this cancer, many countries have implemented cervical cancer screening (CCS), for which the most sensitive strategy is based on primary HPV testing 2 . In case of positivity, the primary HPV test may be completed by additional tests, such as the cervical cytology, for the triage of women with a real risk of having (pre)cancerous lesions and for whom a colposcopy should be performed 3 …”

Section: Introductionmentioning

confidence: 99%

“…2 In case of positivity, the primary HPV test may be completed by additional tests, such as the cervical cytology, for the triage of women with a real risk of having (pre)cancerous lesions and for whom a colposcopy should be performed. 3 The HPV screening test, performed by scraping the cervix with a cytobrush (or alternatively by self-sampling vaginal/ cervical cells), is designed to screen or predict cervical (pre) cancers by detecting a significant amount of persistent hrHPV in the cervical mucosae. Different technologies of HPV screening test are currently available, some of them allowing a partial or even a complete genotyping of the 13 hrHPVs.…”

mentioning

confidence: 99%

Prevalence and significance of HPV DNA detection below the clinical threshold of the commercial kit Alinity m HR‐HPV assay (Abbott)

Node,

Dor,

Puget

et al. 2024

Journal of Medical Virology

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The positive clinical threshold of human papillomavirus (HPV) tests validated for primary cervical cancer screening (CCS) is designed to offer an optimal balance between clinical sensitivity and specificity. However, there may be a gap between the analytical sensitivity of the test and the positive clinical threshold, referred to here as the “gray‐zone.” This study aims to determine the prevalence and significance of HPV results obtained in the gray‐zone in routine practice. Cervical samples obtained in our institution for CCS over a 22‐month‐period were tested with the Alinity m HR‐HPV Assay (Abbott). Clinical and biological data, including cytological results and patients' HPV history were collected. Of the 6101 samples collected, 1.7% had an HPV result in the gray‐zone (102 patients). The proportion of gray‐zone results varied according to HPV genotype, reaching 11.8% of samples with detectable HPV DNA in the case of HPV31/33/52/58 genotypes. Reflex cytologies showed no abnormalities or Atypical Squamous Cells of Undetermined Significance results in 74.6% and 17.9% of cases, respectively. A previous or subsequent HPV‐positive result with a (possibly) identical genotype was observed in 58% and 38% of cases, respectively. Two women with a history of persistent HPV detection had a CIN2+ lesion 1 year after the gray‐zone result. In conclusion, the proportion of HPV results in the gray‐zone varies according to genotype. No cytological abnormality is observed in the majority of cases, but a few rare patients with a history of persistent HPV infection should be closely monitored even if the HPV result is transiently located in the gray‐zone.

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The Role of β1 Integrin/CD29 as a Potential Prognostic Factor for the Risk of Progression to Cervical Carcinoma in HPV-Associated Lesions

Schettino,

Preti,

Vietri

et al. 2024

Medicina

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Background and Objectives: Available evidence reports the overexpression of β1 integrin in dysplastic rather than normal cervical tissue. We aimed to evaluate the involvement of β1 (CD29) integrin in the progressive pathogenesis of cervical intraepithelial neoplasia (CIN). Materials and Methods: From January 2019 to December 2021, we prospectively enrolled women undergoing a colposcopy with a cervical biopsy for abnormal cervical cytology and/or undefined cytology with a positive HPV DNA test and women with relapsing cervical inflammatory disorders. Based on the histopathological results, women were divided into four groups: group A (CIN1), group B (CIN2), group C (CIN3), and group D (no CIN diagnosis) as a control group. Subsequently, cytofluorimetry and immunohistochemical analysis (based on the identified positive cell ratios as follows: ≤10%, negative; 10–25%, 1+ (weak); 25–50%, 2+ (medium); ≥50%, and 3+ (high)) for β1 integrin were carried out. Results: In total, 154 women were included. The average fluorescence intensity in the four groups was 2.35 ± 1.37, 2.73 ± 1.56, 3.09 ± 1.56, and 2.13 ± 1.25 UA from groups A to D, respectively; this figure was significantly different for CIN3 (group C) women relative to the other groups (p = 0.0132). Higher β1 integrin/CD29 concentrations in the CIN groups with HR-HPV 16 and 18 were also detected (p = 0.0292, 0.0367, and 0.0357 respectively for CIN3, CIN2, and CIN1). Immunohistochemistry analysis showed higher results for the CIN3 group compared to controls and all the other groups (p < 0.001). Conclusions: β1/CD29 integrin expression increased with CIN grade, and it was significantly higher in CIN3 lesions. This could be used as a promising screening tool to identify women prone to developing high-grade cervical lesions. However, additional evidence is needed to strengthen these findings.

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Options for triage and implications for colposcopists within European HPV-based cervical screening programmes

Cited by 3 publications

References 82 publications

Recent advances in the cervical screening programme

Recent advances in the cervical screening programme

Prevalence and significance of HPV DNA detection below the clinical threshold of the commercial kit Alinity m HR‐HPV assay (Abbott)

The Role of β1 Integrin/CD29 as a Potential Prognostic Factor for the Risk of Progression to Cervical Carcinoma in HPV-Associated Lesions

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