Paes Eliana Ferreira, de Assis Angela Maria, Teixeira Cirbia S Campos, Aoki Francisco Hideo, Teixeira Julio Cesar
Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
Laboratory of Research in AIDS, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
PLoS One. 2015 Jun 18;10(6):e0130226. doi: 10.1371/journal.pone.0130226. eCollection 2015.
Cervical cancer is caused by high-risk human papillomaviruses (HPV) and viral detection tests aid in the diagnosis of precursor lesions. In the present study, a molecular test for detection of high-risk HPV DNA, called E7-HPV, was standardized and assessed in samples from women with pre-cancerous lesions. The development of the E7-HPV test for detection and genotyping of six high-risk HPV (types 16, 18, 31, 33, 45 and 52), consisted of evaluating primer quality and adjusting the multiplex PCR conditions. Primer design was based on the E7 region of each HPV, and the fluorochrome 6-FAM was added to PCR primers. Viral detection was performed by capillary electrophoresis in automated sequencer in samples obtained from 60 women (55 with ASC-H/HSIL cytology) from August to September 2013. A non-inferiority analysis was conducted with the cobas HPV test as a reference and following international guidelines for the development of new tests. The two tests had a high concordance rate in HPV16 detection (kappa=0.972), with only one discordant case (cervical intraepithelial neoplasia grade 3, negative with cobas and positive for HPV16 by E7-HPV) and complete agreement in HPV18 detection. When comparing detection of all high-risk HPV, three cases were positive with cobas but negative with E7-HPV, and another three cases were negative with cobas but positive with E7-HPV (HPV16, 31 and 52). When we evaluate the cases initially suspected by cytology, the two tests had the same sensitivity in detection CIN2 or worse. In conclusion, the E7-HPV test has satisfactory initial results, and its development can be continued.
宫颈癌由高危型人乳头瘤病毒(HPV)引起,病毒检测试验有助于诊断前驱病变。在本研究中,一种名为E7-HPV的用于检测高危型HPV DNA的分子检测方法在癌前病变女性样本中进行了标准化和评估。用于检测六种高危型HPV(16、18、31、33、45和52型)并进行基因分型的E7-HPV检测方法的开发,包括评估引物质量和调整多重PCR条件。引物设计基于每种HPV的E7区域,并在PCR引物中添加了荧光染料6-FAM。2013年8月至9月,对从60名女性(55名具有不典型鳞状细胞不能排除高度鳞状上皮内病变/高度鳞状上皮内病变细胞学特征)获取的样本,通过自动测序仪中的毛细管电泳进行病毒检测。以cobas HPV检测为参照并遵循新检测方法开发的国际指南进行了非劣效性分析。两种检测方法在HPV16检测中具有较高的一致性率(kappa=0.972),仅有一例不一致病例(宫颈上皮内瘤变3级,cobas检测为阴性,E7-HPV检测HPV16为阳性),在HPV18检测中完全一致。在比较所有高危型HPV的检测结果时,有3例cobas检测为阳性但E7-HPV检测为阴性,另有3例cobas检测为阴性但E7-HPV检测为阳性(HPV16、31和52型)。当我们评估最初由细胞学怀疑的病例时,两种检测方法在检测CIN2或更严重病变方面具有相同的敏感性。总之,E7-HPV检测具有令人满意的初步结果,其开发可以继续。