results - cytology.com.au€¦ · n.melnikova, n.yarovaya, m.zakharenko, i.antonova, a.senchukova,...
TRANSCRIPT
N.Melnikova, N.Yarovaya, M.Zakharenko, I.Antonova, A.Senchukova, N. Babaeva, N.Bolotina, V.Bozhenko
Federal State Budgetary Institution Russian Scientific Center of Roentgenoradiology of the Ministry of Healthcare of
the Russian Federation, 117997 Moscow, Profsoyuznaya str., 86, Russian Federation
Pre
dic
ted
class
ific
ati
on
s
Observed classifications
Percent
–
Correct
LSIL or
less
p=,47368
HSIL+
p=,52632
LSIL
or less 95,00000 1 19
HSIL+ 94,44444 17 1
Total 94,73684 18 20
The
classification
matrix
for 2
groups by
Discriminant
Function
Analysis
Objectives
The aim of this study was to count the
efficiency of liquid-based Pap test and the
possibility of differentiation HSIL+ from LSIL
or less based on the expression of the 24-gene
panel mRNA measurement by quantitative
PCR in the residual media Pap test CellPrep in
postmenopausal women.
Methods 38 postmenopausal women had subsequent
histological examination within 3 months after
the cytodiagnosis by Pap test CellPrep. mRNA
expression of the 21 genes (Ki-67, STK-15,
CCNB1, CCND1, MYC, MYBL2, P16INK4A,
PTEN, BIRC5, BCL2, BAG1, TERT, NDRG1,
ESR1, PGR, HER2, GRB7, MGB1, MMP11,
CTSL2, CD68) and 3 house-keeping genes
(GUSB, HPRT1, B2M) was measured by
quantitative PCR in the Pap test CellPrep
media. The study of this set of genes is
included in the diagnostic kit - GlobalIndex
(GI) - a registered test system for predicting
the recurrence of breast cancer.
Results The histological examination was classified in such clinical
groups: normal epithelium/benign tissue changes (16 patients),
LSIL (3 patients), HSIL (16 patients), squamous cell carcinoma (2
patients), endocervical adenocarcinoma (1 patient). We observed
that 3 cases of LSIL and 1 case of HSIL were false positive and the
positive predictive value for the CellPrep Pap test was 80.95%
95% (CI 65.70% to 90.41%.) The accuracy of the Pap smear was
80% (95% CI 61.43% to 92.29%.) . We discovered that combined
evaluation of the 24 gene expression panel allows, according to the
discriminant analysis, to carry out the correct differentiation for
HSIL+ from (LSIL or less) in 94,74% of cases.
Conclusions
The inclusion of the expression analysis of
24-gene panel by quantitative PCR to the Pap
test CellPrep could lead to more accurate
detecting for severe cervical lesions
The correct classification is mainly influenced
by the estimation of the expression of 6 genes:
MYBL2,HER2,NDRG1,BAG1,GRB7, BCL2.
The estimation of levels ESR1 and MYBL2
mRNA expression has a crucial meaning by
forward stepwise analysis.
2 ml media
HSIL. Histological
examination. (H&Ex400)
1-HSIL. CellPrep Pap test.
(Pap stain x400) Endocervical
adenocarcinoma. (H&Ex400)
Adenocarcinoma CellPrep
Pap test (Pap stain x400)
Median
25%-75%
Min-Max
260
240
220
200
180
160
140
120
100
80
60
40
20
0
Boxplot by Group
Variable: ESR1
ESR
1
b a
120
100
80
60
40
20
0
-20
Boxplot by Group
Variable: MYBL2
MY
BL
2
b a
Groups of histological diagnosis a – LSIL or less; b – HSIL+
The estimation of ESR1 and MYBL2 mRNA levels in groups with histological confirmed
LSIL or less (normal epithelium/benign tissue changes
of the cervix) and HSIL+
Real-time cycler DT
Prime5, Company
DNA-Technology
LLC, Russia