新しい検査で子宮頸がんをより多く発見(New test detects more cases of cervical cancer)

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2024-06-04 カロリンスカ研究所(KI)

カロリンスカ研究所とインスブルック大学の研究者たちは、従来の方法よりも簡便で効果的な子宮頸がんのスクリーニング法を開発しました。この新しい分子検査WID-qCINは、細胞のエピジェネティック変化を自動的に分析し、従来の細胞学的分析を置き換える可能性があります。研究では、2,377のHPV陽性サンプルをWID-qCINと高リスクHPVタイプ16/18の検査で分析し、全ての侵襲性子宮頸がんと93%の重大な前がん病変を検出しました。また、この新検査は従来の方法に比べ、将来的ながんと前がん病変をより高い確率で予測でき、侵襲的なコルポスコピー検査の必要性を40%減少させる可能性があります。

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実世界集団におけるDNAメチル化トリアージを用いた子宮頸癌スクリーニング Cervical cancer screening using DNA methylation triage in a real-world population

Lena Schreiberhuber,James E. Barrett,Jiangrong Wang,Elisa Redl,Chiara Herzog,Charlotte D. Vavourakis,Karin Sundström,Joakim Dillner & Martin Widschwendter
Nature Medicine  Published:04 June 2024
DOI:https://doi.org/10.1038/s41591-024-03014-6

figure 1

Abstract

Cervical cancer (CC) screening in women comprises human papillomavirus (HPV) testing followed by cytology triage of positive cases. Drawbacks, including cytology’s low reproducibility and requirement for short screening intervals, raise the need for alternative triage methods. Here we used an innovative triage technique, the WID-qCIN test, to assess the DNA methylation of human genes DPP6, RALYL and GSX1 in a real-life cohort of 28,017 women aged ≥30 years who attended CC screening in Stockholm between January and March 2017. In the analysis of all 2,377 HPV-positive samples, a combination of WID-qCIN (with a predefined threshold) and HPV16 and/or HPV18 (HPV16/18) detected 93.4% of cervical intraepithelial neoplasia grade 3 and 100% of invasive CCs. The WID-qCIN/HPV16/18 combination predicted 69.4% of incident cervical intraepithelial neoplasia grade 2 or worse compared with 18.2% predicted by cytology. Cytology or WID-qCIN/HPV16/18 triage would require 4.1 and 2.4 colposcopy referrals to detect one cervical intraepithelial neoplasia grade 2 or worse, respectively, during the 6 year period. These findings support the use of WID-qCIN/HPV16/18 as an improved triage strategy for HPV-positive women.

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