Department of Internal Medicine I, Institute of Cancer Research, Medical University of Vienna, Vienna, Austria.
Department of Environmental Health, Center for Public Health, Medical University of Vienna, Vienna, Austria.
Carcinogenesis. 2020 Oct 15;41(10):1318-1328. doi: 10.1093/carcin/bgaa087.
Cervical cancer (CC) is the fourth most common cancer in women; the survival rates depend strongly on its early detection. The Pap test is the most frequently used diagnostic tool, but due to its limited sensitivity/specificity, additional screening tests are needed. Therefore, we evaluated the use of micronucleus (MN) assays with cervical cells for the prediction and diagnosis of CC. MN reflects structural and numerical chromosomal aberrations. A search was performed in Pubmed, Scopus, Thomson ISI and Google Scholar. Subsequently, meta-analyses were performed for different grades of abnormal findings in smears and biopsies from patients which were diagnosed with CC. Results of 21 studies in which findings of MN experiments were compared with data from Pap tests show that higher MN frequencies were found in women with abnormal cells that are indicative for increased cancer risks. MN frequency ratios increased in the order inflammation (2.1) < ASC-US and ASC-H (3.3) < LGSIL (4.4) < HGSIL (8.4). Furthermore, results are available from 17 investigations in which MN were scored in smears from patients with neoplasia. MN rates increased with the degree of neoplasia [CIN 1 (4.6) < CIN 2 (6.5) and CIN 3 (10.8)] and were significantly higher (8.8) in CC patients. Our meta-analysis indicates that the MN assay, which is easy to perform in combination with Pap tests, may be useful for the detection/prediction of CC. However, standardization (including definition of the optimal cell numbers and stains) and further validation is necessary before the MN test can be implemented in routine screening.
宫颈癌（CC）是女性中第四常见的癌症；其存活率在很大程度上取决于早期发现。巴氏涂片检查是最常用的诊断工具，但由于其灵敏度/特异性有限，需要额外的筛查试验。因此，我们评估了使用宫颈细胞中的微核（MN）测定法来预测和诊断 CC。MN 反映了结构和数量染色体畸变。在 Pubmed、Scopus、Thomson ISI 和 Google Scholar 中进行了搜索。随后，对来自被诊断为 CC 的患者的涂片和活检中不同等级异常发现的 meta 分析进行了分析。将 MN 实验结果与巴氏涂片检查数据进行比较的 21 项研究的结果表明，在异常细胞中发现的 MN 频率更高，这些细胞提示癌症风险增加。MN 频率比按炎症（2.1）< ASC-US 和 ASC-H（3.3）< LGSIL（4.4）< HGSIL（8.4）的顺序增加。此外，还有 17 项研究提供了 MN 在有肿瘤患者涂片上评分的结果。MN 率随肿瘤程度增加而增加[CIN 1（4.6）< CIN 2（6.5）和 CIN 3（10.8）]，在 CC 患者中显着增加（8.8）。我们的荟萃分析表明，MN 测定法与巴氏涂片检查相结合，易于操作，可能有助于 CC 的检测/预测。然而，在 MN 试验可以常规筛查之前，需要进行标准化（包括最佳细胞数量和染色剂的定义）和进一步验证。
