Cervical cell lift: A novel triage method for the spatial mapping and grading of precancerous cervical lesions
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Volume
82
Publisher
DOI
10.1016/j.ebiom.2022.104157
Journal
EBIOMEDICINE
ISSN
2352-3964
Metadata
Show full item recordAbstract
Background
Primary HPV screening, due to its low specificity, requires an additional liquid-based cytology (LBC) triage test. However, even with LBC triage there has been a near doubling in the number of patients referred for colposcopy in recent years, the majority having low-grade disease.
Methods
To counter this, a triage test that generates a spatial map of the cervical surface at a molecular level has been developed which removes the subjectivity associated with LBC by facilitating identification of lesions in their entirety. 50 patients attending colposcopy were recruited to participate in a pilot study to evaluate the test. For each patient, cells were lifted from the cervix onto a membrane (cervical cell lift, CCL) and immunostained with a biomarker of precancerous cells, generating molecular maps of the cervical surface. These maps were analysed to detect high-grade lesions, and the results compared to the final histological diagnosis.
Findings
We demonstrated that spatial molecular mapping of the cervix has a sensitivity of 90% (95% CI 69-98) (positive predictive value 81% (95% CI 60-92)) for the detection of high-grade disease, and that AI-based analysis could aid disease detection through automated flagging of biomarker-positive cells.
Interpretation
Spatial molecular mapping of the CCL improved the rate of detection of high-grade disease in comparison to LBC, suggesting that this method has the potential to decisively identify patients with clinically relevant disease that requires excisional treatment.
Authors
Shiraz, A; Egawa, N; Pelt, DM; Crawford, R; Nicholas, AK; Romashova, V; Sasieni, P; Griffin, H; Doorbar, JCollections
- Centre for Cancer Prevention [1179]
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