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BD-ProExC as adjunct molecular marker for improved detection of CIN2(+) after HPV primary screening

Christophe Depuydt, Amin Makar UGent, MAYA RUYMBEKE UGent, Ina Benoy, Annie Vereecken and Johannes Bogers (2011) CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION. 20(4). p.628-637
abstract
Background and Methods: We investigated the efficacy of 8 cervical cancer screening strategies relative to cytology with emphasis on immunocytochemical detection of high-risk human papillomavirus (hrHPV)- induced cell transformation (BD-ProExC) as a tool of triage following primary cytology or hrHPV testing. 3,126 women were tested with BD-SurePath liquid-based cytology, hrHPV PCR genotyping and BD-ProExC immunostaining, and colposcopy verification to calculate sensitivity and positive predictive value (PPV) in detecting cervical intraepithelial neoplasia (CIN2(+)). Results: Compared to cytology screening, double testing with cytology and hrHPV resulted in the same sensitivity with a significant increase in the PPV (relative PPV: 1.83). However, twice as many tests were needed. Cytology with atypical squamous cells of undetermined significance (ASC-US) triage and hrHPV testing showed comparative results to double testing requiring only a small increase in number of tests. Screening for hrHPV subtypes 16/18, and ASC-US triage with hrHPV16/18 resulted in significant reductions in sensitivity (ratio: 0.74 and 0.96, respectively). Primary hrHPV/BD-ProExC screening was significantly more sensitive (ratio: 1.63/1.33), but had a significantly lower PPV (ratio: 0.64/0.88). ASC-US triage by BD-ProExC increased the PPV (ratio: 1.90) but decreased the sensitivity (ratio: 0.96). Primary hrHPV screening followed by BD-ProExC triage, led to significant increases in sensitivity (ratio: 1.30) and PPV (ratio: 2.89), and resulted in 55% fewer referrals for colposcopy. Conclusions: From the investigated screening strategies, primary hrHPV DNA-based screening followed by BD-ProExC triage was determined to be the best screening strategy. Impact: Immunocytological triage could be used to perfect hrHPV primary screening.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
HUMAN-PAPILLOMAVIRUS DNA, SQUAMOUS INTRAEPITHELIAL LESIONS, CERVICAL-CANCER, FOLLOW-UP, IMMUNOCYTOCHEMICAL ASSAY, WOMEN, CYTOLOGY, RISK, NEOPLASIA, IDENTIFICATION
journal title
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
Cancer Epidemiol. Biomarkers Prev.
volume
20
issue
4
pages
628 - 637
Web of Science type
Article
Web of Science id
000288993000013
JCR category
PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
JCR impact factor
4.123 (2011)
JCR rank
11/156 (2011)
JCR quartile
1 (2011)
ISSN
1055-9965
DOI
10.1158/1055-9965.EPI-10-0818
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2078685
handle
http://hdl.handle.net/1854/LU-2078685
date created
2012-04-02 08:37:37
date last changed
2012-04-04 15:36:12
@article{2078685,
  abstract     = {Background and Methods: We investigated the efficacy of 8 cervical cancer screening strategies relative to cytology with emphasis on immunocytochemical detection of high-risk human papillomavirus (hrHPV)- induced cell transformation (BD-ProExC) as a tool of triage following primary cytology or hrHPV testing. 3,126 women were tested with BD-SurePath liquid-based cytology, hrHPV PCR genotyping and BD-ProExC immunostaining, and colposcopy verification to calculate sensitivity and positive predictive value (PPV) in detecting cervical intraepithelial neoplasia (CIN2(+)). 
Results: Compared to cytology screening, double testing with cytology and hrHPV resulted in the same sensitivity with a significant increase in the PPV (relative PPV: 1.83). However, twice as many tests were needed. Cytology with atypical squamous cells of undetermined significance (ASC-US) triage and hrHPV testing showed comparative results to double testing requiring only a small increase in number of tests. Screening for hrHPV subtypes 16/18, and ASC-US triage with hrHPV16/18 resulted in significant reductions in sensitivity (ratio: 0.74 and 0.96, respectively). Primary hrHPV/BD-ProExC screening was significantly more sensitive (ratio: 1.63/1.33), but had a significantly lower PPV (ratio: 0.64/0.88). ASC-US triage by BD-ProExC increased the PPV (ratio: 1.90) but decreased the sensitivity (ratio: 0.96). Primary hrHPV screening followed by BD-ProExC triage, led to significant increases in sensitivity (ratio: 1.30) and PPV (ratio: 2.89), and resulted in 55\% fewer referrals for colposcopy. 
Conclusions: From the investigated screening strategies, primary hrHPV DNA-based screening followed by BD-ProExC triage was determined to be the best screening strategy. 
Impact: Immunocytological triage could be used to perfect hrHPV primary screening.},
  author       = {Depuydt, Christophe and Makar, Amin and RUYMBEKE, MAYA and Benoy, Ina and Vereecken, Annie and Bogers, Johannes},
  issn         = {1055-9965},
  journal      = {CANCER EPIDEMIOLOGY BIOMARKERS \& PREVENTION},
  keyword      = {HUMAN-PAPILLOMAVIRUS DNA,SQUAMOUS INTRAEPITHELIAL LESIONS,CERVICAL-CANCER,FOLLOW-UP,IMMUNOCYTOCHEMICAL ASSAY,WOMEN,CYTOLOGY,RISK,NEOPLASIA,IDENTIFICATION},
  language     = {eng},
  number       = {4},
  pages        = {628--637},
  title        = {BD-ProExC as adjunct molecular marker for improved detection of CIN2(+) after HPV primary screening},
  url          = {http://dx.doi.org/10.1158/1055-9965.EPI-10-0818},
  volume       = {20},
  year         = {2011},
}

Chicago
Depuydt, Christophe, Amin Makar, MAYA RUYMBEKE, Ina Benoy, Annie Vereecken, and Johannes Bogers. 2011. “BD-ProExC as Adjunct Molecular Marker for Improved Detection of CIN2(+) After HPV Primary Screening.” Cancer Epidemiology Biomarkers & Prevention 20 (4): 628–637.
APA
Depuydt, C., Makar, A., RUYMBEKE, M., Benoy, I., Vereecken, A., & Bogers, J. (2011). BD-ProExC as adjunct molecular marker for improved detection of CIN2(+) after HPV primary screening. CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 20(4), 628–637.
Vancouver
1.
Depuydt C, Makar A, RUYMBEKE M, Benoy I, Vereecken A, Bogers J. BD-ProExC as adjunct molecular marker for improved detection of CIN2(+) after HPV primary screening. CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION. 2011;20(4):628–37.
MLA
Depuydt, Christophe, Amin Makar, MAYA RUYMBEKE, et al. “BD-ProExC as Adjunct Molecular Marker for Improved Detection of CIN2(+) After HPV Primary Screening.” CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION 20.4 (2011): 628–637. Print.