Open AccessThe application of BMRT-HPV viral load to secondary screening strategies for cervical cancer
Author(s) -
Lyufang Duan,
Hui Du,
Chun Wang,
Xia Huang,
Xinfeng Qu,
Bin Shu,
Yan Liu,
Wei Zhang,
Xiaohui Duan,
Lihui Wei,
Jerome L. Belinson,
Ruifang Wu
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0232117
Subject(s) - cervical cancer , viral load , papillomaviridae , medicine , virology , cervical cancer screening , oncology , cancer , human immunodeficiency virus (hiv)
Objective Evaluate the significance of BMRT HPV assay viral load and its performance for secondary screening. Methods BMRT-HPV reports type-specific viral loads/10,000 cells. We tested 1,495 physician collected, stored specimens from Chinese Multiple-center Screening Trial (CHIMUST), that were positive by Cobas, SeqHPV, and/or Cytology (≥LSIL); and 2,990 age matched, negatives in a nested case control study. We explored the relationship between BMRT HR-HPV viral load and cervical lesions, determined alternative CIN2+ cut-points by ROC curve, and evaluated BMRT HR-HPV for primary / secondary cervical cancer screening. Results The viral loads of HPV16/18, 12 other subtypes HR-HPV and 14 HR-HPV were statistically different in all grades of cervical lesions ( P <0.05, among which HPV16, 33 and 58 showed the strongest relationship ( P <0.01). The viral load of HR-HPV also increased with the grade of cervical lesions ( P <0.05). The sensitivity for CIN2+ and CIN3+ of BMRT was comparable to Cobas (92.6% vs 94.3%, 100% vs 100%, P >0.05), specificity was higher than Cobas (84.8% vs 83.3%, 83.5% vs 82.0%, P <0.001). When using HPV16/18 viral load(log cut-point ≥3.2929), plus the viral-load of 12 other subtypes (log cut-point ≥3.9625) as secondary triage, compared with Cobas HPV16/18+ plus cytology ≥ASC-US as triage, the sensitivities for CIN2+ and CIN3+ were similar ( P >0.05). However, the BMRT HR-HPV viral load combined with subtypes did not require cytology. Conclusion BMRT is as sensitive as Cobas4800 for primary cervical cancer screening. BMRT HR-HPV viral load combined with subtypes can be used as a secondary strategy for cervical cancer screening, especially for areas with insufficient cytological resources.