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Cervical cell lift: A novel triage method for the spatial mapping and grading of precancerous cervical lesions.
- Source :
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EBioMedicine [EBioMedicine] 2022 Aug; Vol. 82, pp. 104157. Date of Electronic Publication: 2022 Jul 18. - Publication Year :
- 2022
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Abstract
- Background: Primary HPV screening, due to its low specificity, requires an additional liquid-based cytology (LBC) triage test. However, even with LBC triage there has been a near doubling in the number of patients referred for colposcopy in recent years, the majority having low-grade disease.<br />Methods: To counter this, a triage test that generates a spatial map of the cervical surface at a molecular level has been developed which removes the subjectivity associated with LBC by facilitating identification of lesions in their entirety. 50 patients attending colposcopy were recruited to participate in a pilot study to evaluate the test. For each patient, cells were lifted from the cervix onto a membrane (cervical cell lift, CCL) and immunostained with a biomarker of precancerous cells, generating molecular maps of the cervical surface. These maps were analysed to detect high-grade lesions, and the results compared to the final histological diagnosis.<br />Findings: We demonstrated that spatial molecular mapping of the cervix has a sensitivity of 90% (95% CI 69-98) (positive predictive value 81% (95% CI 60-92)) for the detection of high-grade disease, and that AI-based analysis could aid disease detection through automated flagging of biomarker-positive cells.<br />Interpretation: Spatial molecular mapping of the CCL improved the rate of detection of high-grade disease in comparison to LBC, suggesting that this method has the potential to decisively identify patients with clinically relevant disease that requires excisional treatment.<br />Funding: CRUK Early Detection Project award, Jordan-Singer BSCCP award, Addenbrooke's Charitable Trust, UK-MRC, Janssen Pharmaceuticals/Advanced Sterilisation Products, and NWO.<br />Competing Interests: Declaration of interests Dr Egawa, Dr Shiraz and Prof Doorbar report grants from Janssen Pharmaceuticals/Advanced Sterilization Products (ASP). Dr Egawa was working for Maruho Co., Ltd as a consultant outside of this work. Ms Nicholas, Ms Romashova, Dr Griffin, Prof Sasieni and Dr Crawford have nothing to disclose pertaining to this project.<br /> (Copyright © 2022. Published by Elsevier B.V.)
- Subjects :
- Cervix Uteri
Early Detection of Cancer methods
Female
Humans
Papillomaviridae
Pilot Projects
Triage
Vaginal Smears methods
Papillomavirus Infections
Precancerous Conditions diagnosis
Uterine Cervical Neoplasms diagnosis
Uterine Cervical Neoplasms pathology
Uterine Cervical Dysplasia diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 2352-3964
- Volume :
- 82
- Database :
- MEDLINE
- Journal :
- EBioMedicine
- Publication Type :
- Academic Journal
- Accession number :
- 35863292
- Full Text :
- https://doi.org/10.1016/j.ebiom.2022.104157