A kettős immunfestésű citológia jelentősége a méhnyakrák rizikójának becslésében
Cikk címe: A kettős immunfestésű citológia jelentősége a méhnyakrák rizikójának becslésében
Szerzők: Dr. Melczer Zsolt, Dr. Pogány Péter
Intézmények: Semmelweis Egyetem II. sz. Szülészeti és Nőgyógyászati Klinika, Medserv Kft.
Évfolyam: XVIII. évfolyam
Lapszám: 2019. / 04. lapszám
Oldal: 37-41
Rovat: KLINIKUM
Alrovat: NŐGYÓGYÁSZAT
Absztrakt:
A méhnyakszűrés metodikája napjainkban átalakulóban van. A citológiai szűrés mellett egyre nagyobb hangsúlyt kapnak a magas kockázatú HPV (hrHPV) DNS kimutatásán alapuló tesztek. A citológia és a hrHPV DNS kimutatáson alapuló tesztek szenzitivitása, illetve specificitása közötti különbségek miatt, egyre inkább létfontosságú a nők számára az új szűrési és diagnosztikai technológiák bevezetése, hogy minél több új eset legyen megelőzhető. A CINtec® PLUS Cytology teszt azokat a sejteket azonosítja a cervikális sejtkenetből, melyeknél a HPV a sejt osztódási ciklusát megszakította (p16/ki-67 pozitív), megerősítve ezzel a transzformálódó HPV fertőzés jelenlétét, pontosan jelezve azon nők csoportját, akiknél a rákmeg előző állapot kialakulásának a veszélye nagyobb.
Abstract:
The methodology of cervical cancer screening is about to change. Beside cytology-based screening, the high-risk HPV (hrHPV) DNA detection is getting more enhanced. The difference in specificity and sensitivity of cytology and hrHPV DNA detection respectively, it is getting more and more essential to introduce novel screening and diagnostic methods. The CINtec® PLUS Cytology test identifies those cervical cells, where the HPV disrupted the cell cycle (p16/Ki-67 positive), confirming the trans forming HPV infection, to identify women at highest risk for the presence of a high-grade cervical disease.
XVIII. évfolyam
2019. / 04. lapszám / Május
| Szerző | Intézmény |
|---|---|
| Dr. Melczer Zsolt | Semmelweis Egyetem II. sz. Szülészeti és Nőgyógyászati Klinika |
| Dr. Pogány Péter | Medserv Kft. |
[1] Szentirmay Z, Veleczki Zs., Kásler M: Humán papillomavírus asszociált méhnyak-megbetegedések Magyar – országon: epidemiológia és a HPV-típusok összefüggése a párhuzamosan végzett citológiai diagnózissal Orv Hetil. 2017; 158(31): 1213–1221
[2] Bulkmans NW, Rozendaal L, Snijders PJ, Voorhorst FJ, Boeke AJ, Zandwijken GR, van Kemenade FJ, Verhei – jen RH, Groningen K, Boon ME, Keuning HJ, van Ballegooijen M, van den Brule AJ & Meijer CJ: POBASCAM, a population-based randomized controlled trial for implementation of high-risk HPV testing in cervical screening: design, methods and baseline data of 44,102 women. Int J Cancer, (2004). vol. 110, no. 1, pp. 94-101
[3] Bulkmans NW, Berkhof J, Rozendaal L, van Kemenade FJ, Boeke AJ, Bulk S, Voorhorst FJ, Verheijen RH, van Groningen K, Boon ME, Ruitinga W, van Ballegooijen M, Snijders PJ & Meijer CJ: Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomised controlled implementation trial. Lancet, (2007). vol. 370, no. 9601, pp. 1764-1772
[4] Kitchener HC, Almonte M, Thomson C, Wheeler P, Sargent A, Stoykova B, Gilham C, Baysson H, Roberts C, Dowie R, Desai M, Mather J, Bailey A, Turner A, Moss S & Peto J: HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial. Lancet Oncol, (2009b). vol. 10, no. 7, pp. 672-682
[5] Kotaniemi-Talonen L, Nieminen P, Anttila A & Hakama M: Routine cervical screening with primary HPV testing and cytology triage protocol in a randomised setting. Br J Cancer, (2005) vol. 93, no. 8, pp. 862-867
[6] Leinonen M, Nieminen P, Kotaniemi-Talonen L, Malila N, Tarkkanen J, Laurila P & Anttila A: Age-specific evaluation of primary human papillomavirus screening vs conventional cytology in a randomized setting. J Natl Cancer Inst., (2009) vol. 101, no. 23, pp. 1612-1623
[7] Naucler P, Ryd W, Tornberg S, Strand A, Wadell G, Elfgren K, Radberg T, Strander B, Forslund O, Hansson BG, Hagmar B, Johansson B, Rylander E & Dillner J Efficacy of HPV DNA testing with cytology triage and/or repeat HPV DNA testing in primary cervical cancer screening. J Natl Cancer Inst, (2009) vol. 101, no. 2, pp. 88- 99
[8] Naucler P, Ryd W, Tornberg S, Strand A, Wadell G, Elfgren K, Radberg T, Strander B, Johansson B, Forslund O, Hansson BG, Rylander E & Dillner J: Human papillomavirus and Papanicolaou tests to screen for cervical cancer. N Engl J Med, (2007) vol. 357, no. 16, pp. 1589-1597
[9] Rijkaart DC, Berkhof J, Rozendaal L, van Kemenade FJ, Bulkmans NW, Heideman DA, Kenter GG, Cuzick J, Snijders PJ & Meijer CJ: Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial. Lancet Oncol., (2012) vol. 13, no. 1, pp. 78-88
[10] Ronco G: HPV test shows low sensitivity of Pap screen in older women – Authors’ reply. Lancet Oncol, (2010) vol. 11, no. 6, pp. 510-511
[11] Ronco G, Giorgi-Rossi P, Carozzi F, Dalla Palma P, Del Mistro A, De Marco L, De Lillo M, Naldoni C, Pierotti P, Rizzolo R, Segnan N, Schincaglia P, Zorzi M, Confortini M & Cuzick J: Human papillomavirus testing and liquidbased cytology in primary screening of women younger than 35 years: results at recruitment for a randomised controlled trial. Lancet Oncol, (2006a) vol. 7, no. 7, pp. 547-555
[12] Ronco G, Segnan N, Giorgi-Rossi P, Zappa M, Casadei GP, Carozzi F, Dalla Palma P, Del Mistro A, Folicaldi S, Gillio-Tos A, Nardo G, Naldoni C, Schincaglia P, Zorzi M, Confortini M & Cuzick J: Human papillomavirus testing and liquid-based cytology: results at recruitment from the new technologies for cervical cancer randomized controlled trial. J Natl Cancer Inst, (2006b) vol. 98, no. 11, pp. 765-774
[13] Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, Gillio-Tos A, Minucci D, Naldoni C, Rizzolo R, Schincaglia P, Volante R, Zappa M, Zorzi M, Cuzick J & Segnan N Results at recruitment from a randomized controlled trial comparing human papillomavirus testing alone with conventional cytology as the primary cervical cancer screening test, J Natl Cancer Inst, (2008) vol. 100, no. 7, pp. 492-501
[14] Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, Ghiringhello B, Girlando S, Gillio- Tos A, De Marco L, Naldoni C, Pierotti P, Rizzolo R, Schincaglia P, Zorzi M, Zappa M, Segnan N & Cuzick J: Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol, (2010) vol. 11, no. 3, pp. 249-257
[15] Mayrand MH, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A, Ratnam S, Coutlee F & Franco EL: Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med, (2007). vol. 357, no. 16, pp. 1579-1588
[16] Sankaranarayanan R, Nene BM, Shastri SS, Jayant K, Muwonge R, Budukh AM, Hingmire S, Malvi SG, Thorat R, Kothari A, Chinoy R, Kelkar R, Kane S, Desai S, Keskar VR, Rajeshwarkar R, Panse N & Dinshaw KA: HPV screening for cervical cancer in rural India. N Engl J Med, (2009) vol. 360, no. 14, pp. 1385-1394
[17]Wright, TC, Stoler, MH, Behrens CM, Sharma, A, Zhang G, Wright, TL: Primary cervical cancer screening with human papillomavirus: End of study results from the ATHENA study using HPV as the first-line screening test Gynecologic Oncology (2015) vol. 136 pp. 189–197
[18]Wright, TC, Stoler, MH, Shagufta, A, Behrens, C: Know – ledge of Patients’ Human Papillomavirus Status at the Time of Cytologic Review Significantly Affects the Performance of Cervical Cytology in the ATHENA StudyAm J Clin Pathol, (2016) 146:391-398
[19] Kisser A und Zechmeister-Koss I.p16/Ki-67 Dual Stain zur Triage von PAP III/IIID Befunden im Screening auf Gebärmutterhalskrebs. LBI-HTA Projektbericht Nr.: 72; 2013. Wien: Ludwig Boltzmann Institut für Health Technology Assessment
[20] Bladé A, Saladrigues M del P, Gimferrer MC, et al. Guía de cribado del cáncer de cuello de útero en España, 2014. Rev Española Patol. 2014;47(1):1-43.
[21] Sociedade Portuguesa de Ginecologia – Secção Por – tuguesa de Colposcopia e Patologia Cervico-vulvovaginal. Consenso Sobre Infecção Por HPV E Neoplasia Intraepitelial Do Colo Vulva E Vagina 2014. Coimbra; 2014.
[22] Schmidt D, Bergeron C, Denton KJ, Ridder R: p16/ki-67 dual-stain cytology in the triage of ASCUS and LSIL papanicolaou cytology: results from the European equivocal or mildly abnormal Papanicolaou cytology study. Cancer Cytopathol. 2011;119(3):158-166. doi:10.1002/ cncy.20140.
[23] Killeen JL, Dye T, Grace C, Hiraoka M: Improved abnormal pap smear triage using cervical cancer biomarkers. J Low Genit Tract Dis. 2014;18(1):1-7. doi:10.1097/LGT. 0b013e31828aeb39.
[24]Wentzensen N, Schwartz L, Zuna RE, et al.: Per – formance of p16/Ki-67 immunostaining to detect cervical cancer precursors in a colposcopy referral population. Clin Cancer Res. 2012;18(15):4154-4162. doi:10.1158/ 1078-0432.CCR-12-0270.
[25] Gray NM, Sharp L, Cotton SC et al.: Psychological effects of a low-grade abnormal cervical smear test re – sult: anxiety and associated factors. Br J Cancer. 2006; 94(9):1253-1262. doi:10.1038/sj.bjc.6603086.
[26] Petry KU, Schmidt D, Scherbring S, et al.: Triaging Pap cytology negative, HPV positive cervical cancer screening results with p16/Ki-67 Dual-stained cytology. Gyne – col Oncol. 2011;121(3):505-509. doi:10.1016/j.ygyno. 2011.02.033.
[27] Castle PE, Stoler MH, Wright TC, Sharma A, Wright TL, Behrens CM: Performance of carcinogenic human papillomavirus (HPV) testing and HPV16 or HPV18 genotyping for cervical cancer screening of women aged 25 years and older: a subanalysis of the ATHENA study. Lancet Oncol. 2011;12(9):880-890. doi:10.1016/S1470- 2045(11)70188-7.
[28] Uijterwaal MH, Polman NJ, Witte BI, et al.: Triaging HPVpositive women with normal cytology by p16/Ki-67 dualstained cytology testing: Baseline and longitudinal data. Int J Cancer. 2014;136(10):2361-2368. doi:10.1002 /ijc.29290.
[29] Ikenberg H, Bergeron C, Schmidt D et al.: Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology: results of the PALMS study. J Natl Cancer Inst. 2013;105(20):1550-1557. doi:10.1093/jnci/djt235.
[30] Uijterwaal MH, Witte BI, Van Kemenade FJ et al.: Triaging borderline/mild dyskaryotic Pap cytology with p16/Ki-67 dual-stained cytology testing: cross-sectional and longitudinal outcome study. Br J Cancer. 2014; 110(6):1579-1586. doi:10.1038/bjc.2014.34.
[31]Waldstrøm M, Christensen RK, Ørnskov D.: Evaluation of p16(INK4a)/Ki-67 dual stain in comparison with an mRNA human papillomavirus test on liquid-based cytology samples with low-grade squamous intraepithelial lesion. Cancer Cytopathol. 2013;121(3):136-145. doi: 10.1002/cncy.21233.
[32]Wentzensen N, Fetterman B, Castle PE et al.: p16/Ki-67 dual stain cytology for detection of cervical precancer in HPV-positive women. J Natl Cancer Inst 2015;107: djv257.
[33] Gustinucci D, Rossi PG, Cesarini E, et al. Passamonti B: Use of cytology, E6/E7 mRNA, and p16 INK4a –Ki-67 to define the management of human papillomavirus (HPV)– positive women in cervical cancer screening. Am J Clin Pathol 2016;145:35–45.
[34]Wright TC, Jr, Behrens CM, Ranger-Moore J et al.: Triaging HPV-positive women with p16/Ki-67 dual-stained cytology: results from a sub-study nested into the ATHENA trial. Gynecol Oncol 2017;144:51–6.
[35] Ferlay J, Soerjomataram I, Ervik M, et al.: GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11. GLOBOCAN 2012 v10. 2013
[36] Dijkstra MG, Snijders PJF, Arbyn M, Rijkaart DC, Berkhof J, Meijer CJLM: Cervical cancer screening: on the way to a shift from cytology to full molecular screening. Ann Oncol. 2014;25(5):927-935. doi:10.1093/annonc/ mdt538
[37] Arbyn M, Sanjosé S De, Saraiya M et al.: EUROGIN 2011 roadmap on prevention and treatment of HPV-related disease. Int J Cancer. 2012;131(9):1969-1982. doi:10.1002/ijc.27650.
[38] Humphries C: Screening: Testing times. Nature. 2012; 488:S8-S9