Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, Florida 33136, United States of America.
Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, Florida 33136, United States of America.
Anal Chem. 2023 Sep 12;95(36):13488-13496. doi: 10.1021/acs.analchem.3c01723. Epub 2023 Aug 22.
Cervical cancers constitute a large disease burden in developing countries, with the human papillomavirus (HPV) being responsible for most cervical lesions. Many regions in low-resource countries lack adequate access to sensitive point-of-care (POC) screening tools, preventing timely diagnosis and treatment. To reduce screening barriers, we developed a POC HPV molecular test that detects 14 high-risk HPV types in 30 min in a single assay. We introduced innovations to the underlying amplification (recombinase polymerase amplification) and detection methodologies such as improved probe design, reagent lyophilization, and pipette-less processing to increase sensitivity while enabling minimally trained personnel to conduct reproducible testing. Based on 198 clinically derived samples, we demonstrated a sensitivity of 93% and a specificity of 73% compared to an FDA-approved polymerase chain reaction-based clinical method. Our modified pipette-less simplified assay had a sensitivity of 96% and a specificity of 83%. The application of our assay is intended as a near-patient screening tool with further evaluation by a clinician for confirmation.
宫颈癌在发展中国家造成了巨大的疾病负担,人乳头瘤病毒(HPV)是导致大多数宫颈病变的罪魁祸首。许多资源匮乏的国家缺乏足够的敏感性即时护理(POC)筛查工具,无法及时进行诊断和治疗。为了减少筛查障碍,我们开发了一种 POC HPV 分子检测方法,可在 30 分钟内一次性检测 14 种高危 HPV 型。我们对基础扩增(重组酶聚合酶扩增)和检测方法进行了创新,例如改进探针设计、试剂冻干和无移液处理,以提高灵敏度,同时使训练有素的人员能够进行可重复的测试。基于 198 个临床样本,与经 FDA 批准的基于聚合酶链反应的临床方法相比,我们的检测方法显示出 93%的灵敏度和 73%的特异性。我们改良的无移液简化检测方法的灵敏度为 96%,特异性为 83%。我们的检测方法旨在作为一种床边筛查工具,由临床医生进一步评估以确认。