title: Detection of high-risk human papillomavirus using menstrual blood in women with high-grade squamous intraepithelial lesions or high-risk human papillomavirus infections: A pilot study.
abstract: OBJECTIVE
  Few studies have reported that human papillomavirus (HPV) tests using menstrual blood (MB) may be a convenient and effective screening modality for cervical cancer. Therefore, we aimed to investigate the efficacy of detecting high-risk (HR)-HPV from MB in women with high-grade squamous intraepithelial lesions or HR-HPV infections dependent on menstrual days.
  
  
  METHODS
  In this prospective exploratory pilot study, a clinical trial was conducted in 19 women. On enrollment into the study, gynecologists collected cervical cells. On the first and second day of menstruation, MB was self-collected by patients using a sanitary pad with a filter. The distribution of HPVs from MB and the accuracy of menstrual HR-HPV tests were evaluated using HPV genotyping. The agreement rate of detecting HR-HPVs using cervical and MB samples was also investigated.
  
  
  RESULTS
  The sensitivity, specificity, positive and negative predictive values of the MB HR-HPV test for detecting cervical intraepithelial neoplasia (CIN) 3 or worse were 87.5%, 45.5%, 53.8%, and 83.3%, respectively, during both menstrual cycle day (MCD) 1 and 2 and MCD 1 only; and 62.5%, 27.3%, 38.5%, and 50.0%, respectively, during MCD 2 only. For CIN 3 or worse, the agreement rate between positive cervical and MB HR-HPV test results was 87.5% during MCD 1 and 62.5% during MCD 2.
  
  
  CONCLUSIONS
  We demonstrated the possibility of using the MB HPV test as a screening modality for cervical cancer.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Banghyun
authors.initials: B
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-Si, Gyeonggi-do, Republic of Korea.
authors.forename: Hye-Yon
authors.initials: HY
authors.lastname: Cho
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.
authors.forename: Kum Jin
authors.initials: KJ
authors.lastname: Jeon
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.|Seoul National University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Kidong
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.|Seoul National University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Jung Ryeol
authors.initials: JR
authors.lastname: Lee
authors.affiliation: Goodgene Inc. Koyang-Si, Gyeonggi-do, Republic of Korea.
authors.forename: Jung Joo
authors.initials: JJ
authors.lastname: Moon
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.|Seoul National University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Hong
authors.initials: JH
authors.lastname: No
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam-Si, Gyeonggi-Do, Republic of Korea.|Seoul National University, School of Medicine, Seoul, Republic of Korea.
authors.forename: Yong-Beom
authors.initials: YB
authors.lastname: Kim
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000592:standards*; D005260:Female; D006801:Humans; D008598:Menstruation / Q000097:blood*; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000097:blood*; D010865:Pilot Projects; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000097:blood*; D055815:Young Adult
keywords: cervical intraepithelial neoplasia; genotyping technique; high-grade squamous intraepithelial lesion; human papillomavirus; menstruation