title: Human papillomavirus DNA detection in menstrual blood from patients with cervical intraepithelial neoplasia and condyloma acuminatum.
abstract: The Papanicolaou test generates pain and embarrassment, and cytology screening has limited sensitivity for detection of cervical neoplasia. These factors urge the use of another screening test that can overcome these limitations. We explore a completely noninvasive method using detection of human papillomavirus (HPV) DNA in women's menstrual blood (MB). The participants were divided into 3 cohorts: (i) 235 patients with cervical intraepithelial neoplasia 3 (CIN 3) (n = 48), CIN 2 (n = 60), CIN 1 (n = 58), or condyloma acuminatum (CAC) (n = 69) before treatment or remission; (ii) from the first cohort of patients, 108 CIN 3 or CIN 2 patients after treatment and 62 CIN 1 or CAC patients after remission; and (iii) 323 apparently normal subjects (ANS) without any cervical disease. The HPV genotypes of the infected patients were confirmed by direct sequencing. Quantitative real-time PCR (QRT-PCR) was used to measure the MB HPV16 load for 15 infected patients. Results showed that the sensitivity, specificity, and positive and negative predictive values for detection of MB HPV DNA in samples from patients with CIN or CAC were 82.8%, 93.1%, 90.0%, and 87.9%, respectively. Moreover, MB HPV DNA was found in samples from 22.2% of CIN 3 or CIN 2 patients after treatment, 0.0% of CIN 1 or CAC patients after remission, and 8.1% of ANS, 4 of whom were found to have CIN 1 or CAC. Furthermore, QRT-PCR showed that the normalized MB HPV16 DNA copy numbers in samples from patients with CIN 1 to CIN 3 were significantly increased. These preliminary results suggested that MB HPV DNA is a potential noninvasive marker for these premalignant cervical diseases.
authors.affiliation: State Key Laboratory in Oncology in South China, Sir Y K Pao Centre for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. cesar01@netvigator.com
authors.forename: Sze Chuen Cesar
authors.initials: SC
authors.lastname: Wong
authors.forename: Thomas Chi Chuen
authors.initials: TC
authors.lastname: Au
authors.forename: Sammy Chung Sum
authors.initials: SC
authors.lastname: Chan
authors.forename: Charles Ming Lok
authors.initials: CM
authors.lastname: Chan
authors.forename: Money Yan Yee
authors.initials: MY
authors.lastname: Lam
authors.forename: Benny Chung Ying
authors.initials: BC
authors.lastname: Zee
authors.forename: Wei Mei
authors.initials: WM
authors.lastname: Pong
authors.forename: Anthony Tak Cheung
authors.initials: AT
authors.lastname: Chan
mesh_terms: D000293:Adolescent; D000328:Adult; D001769:Blood / Q000821:virology*; D003218:Condylomata Acuminata / Q000821:virology*; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D005838:Genotype; D006801:Humans; D008598:Menstruation / Q000097:blood*; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000821:virology*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000821:virology*
chemical_list: D004279:DNA, Viral