ABSTRACT
Background: Methylation of the human papillomavirus (HPV) DNA has been proposed as a novel biomarker. Here, we correlated the mean methylation level of 12 CpG sites within the L1 gene, to the histological grade of cervical precancer and cancer. We assessed whether HPV L1 gene methylation can predict the presence of high-grade disease at histology in women testing positive for HPV16 genotype. Methods: Pyrosequencing was used for DNA methylation quantification and 145 women were recruited. Results: We found that the L1 HPV16 mean methylation (±SD) significantly increased with disease severity (cervical intraepithelial neoplasia [CIN] 3, 17.9% [±7.2] vs CIN2, 11.6% [±6.5], P < .001 or vs CIN1, 9.0% [±3.5], P < .001). Mean methylation was a good predictor of CIN3+ cases; the area under the curve was higher for sites 5611 in the prediction of CIN2+ and higher for position 7145 for CIN3+. The evaluation of different methylation thresholds for the prediction of CIN3+ showed that the optimal balance of sensitivity and specificity (75.7% and 77.5%, respectively) and positive and negative predictive values (74.7% and 78.5%, respectively) was achieved for a methylation of 14.0% with overall accuracy of 76.7%. Conclusions: Elevated methylation level is associated with increased disease severity and has good ability to discriminate HPV16-positive women that have high-grade disease or worse.
Subject(s)
Capsid Proteins/genetics , DNA Methylation , Oncogene Proteins, Viral/genetics , Papillomavirus Infections/diagnosis , Uterine Cervical Diseases/diagnosis , Adult , Aged , CpG Islands , DNA, Viral/chemistry , Female , Genotype , Greece , Human papillomavirus 16 , Humans , Linear Models , Middle Aged , Prospective Studies , Sensitivity and Specificity , United Kingdom , Uterine Cervical Diseases/virology , Young Adult , Uterine Cervical Dysplasia/diagnosis , Uterine Cervical Dysplasia/virologyABSTRACT
Endometrial cancer is the most common malignancy of the female genital tract while aberrant DNA methylation seems to play a critical role in endometrial carcinogenesis. Galanin's expression has been involved in many cancers. We developed a new pyrosequencing assay that quantifies DNA methylation of galanin's receptor-1 (GALR1). In this study, the preliminary results indicate that pyrosequencing methylation analysis of GALR1 promoter can be a useful ancillary marker to cytology as the histological status can successfully predict. This marker has the potential to lead towards better management of women with endometrial lesions and eventually reduce unnecessary interventions. In addition it can provide early warning for women with negative cytological result.
Subject(s)
DNA Methylation/genetics , DNA/analysis , DNA/chemistry , Endometrial Neoplasms/genetics , Endometrium/chemistry , Sequence Analysis, DNA/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , ROC CurveABSTRACT
OBJECTIVE: To compare the clinical efficiency of two commercially available HPV DNA detection and typing tests. The CLART HPV2 test, a novel HPV test based on DNA microarrays that can identify 35 HPV genotypes, was compared to the Linear Array HPV Genotyping (LA) test, a more widely used test able to identify 37 HPV genotypes. STUDY DESIGN: The CLART test was evaluated by comparing the genotyping results of 538 ThinPrep Pap tests with the LA test as well as with the cytological and histological findings. RESULTS: The exact same types and results were identified in 86.1% of the samples (kappa = 0.74). The tests showed excellent agreement in HPV positivity and identification of single and multiple infections (concordance rate 88.7%, kappa = 0.827). CONCLUSION: The CLART test demonstrated results comparable to those of the LA test in clinical sensitivity as measured by the positive predictive value of CIN2+ in ASCUS (67.3% vs. 57.1%), while overall it exhibited higher sensitivity, specificity, positive and negative predictive values and area under curves than the LA test in all cytological and histological subgroups analyzed.
Subject(s)
Human Papillomavirus DNA Tests/standards , Papillomaviridae/genetics , Papillomavirus Infections , Reagent Kits, Diagnostic/standards , Adult , Aged , Colposcopy , DNA, Viral/genetics , Female , Genotype , Humans , Middle Aged , Papillomaviridae/classification , Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Papillomavirus Infections/genetics , Papillomavirus Infections/virology , Reproducibility of Results , Sensitivity and Specificity , Uterine Cervical Diseases/diagnosis , Uterine Cervical Diseases/virology , Vaginal Smears/methods , Young AdultABSTRACT
Nucleic acids of human papillomavirus (HPV) isolated by manual extraction method (AmpliLute) and automated MagNA pure system were compared and evaluated with cytohistological findings in 253 women. The concordance level between AmpliLute and MagNA was very good 93.3% (κ = 0.864, P < .0001). Overall HPVpositivity detected by AmpliLute was 57.3% (30.4% as single and 27% as multiple infections) in contrast to MagNA 54.5% (32% and 23%, resp.). Discrepant results observed in 25 cases: 11 MagNA(-)/AmpliLute(+), 10 of which had positive histology; 5 MagNA(+)/AmpliLute(-) with negative histology; 8 MagNA(+)/AmpliLute(+): in 7 of which AmpliLute detected extra HPV genotypes and 1 MagNA(invalid)/AmpliLute(+) with positive histology. Both methods performed well when compared against cytological (area under curve (AUC) of AmpliLute 0.712 versus 0.672 of MagNA) and histological diagnoses (AUC of AmpliLute 0.935 versus 0.877 of MagNA), with AmpliLute showing a slightly predominance over MagNA. However, higher sensitivities, specificities, and positive/negative predictive values were obtained by AmpliLute.
