Andreas M. Kaufmann (Germany)
Laboratory of Tumour Immunology, Clinic for Gynecology, Campus Benjamin Franklin Charite-Universitätsmedizin Berlin corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of HealthPresenter of 2 Presentations
Multiplexed technologies (ID 73)
MULTIPLEXED MOLECULAR PROFILING BY QUANTIGENE 2.0 FROM PRIMARY CERVICAL SMEAR SAMPLES DETECTS DYSPLASIA WITH HIGH PRECISION (ID 960)
Abstract
Introduction
Persistent infection by Human Papillomaviruses (HPV) is characterized by viral oncogene expression and upregulation of cellular proteins that can be regarded as biomarkers for transformation. The oncoproteins E6 and E7 have pleiotropic effects and interact with cellular proteins regulating proliferation, tumor suppressors, (cancer) stem cell markers, and tumor markers. The strength of expression correlates to dysplasia stage and progression.
Methods
A multiplexed mRNA quantifying assay based on Luminex/QuantiGene 2.0 technology platform (Thermo Fisher Scientific) was developed. It combines detection of the E7 oncogene of 18 HPV genotypes and 18 cellular biomarker expression, routinely used for diagnosis, markers for cancer stem cells, tumor markers and housekeeping genes for normalization. All mRNA species are detected simultaneously from a crude lysate of a cervical smear sample taken into Thinprep/PreserveCyte. In a prospective trial 1400 consecutively collected samples were measured and data used for logistic regression and ROC analyses.
Results
The assay has a high sensitivity detecting less than 40 CaSki or HeLa cells. It genotypes 18 HR-HPVs and detects leading types in multiple infections with highest E7 expression. Logistic regression identified E7 expression strength as most informative biomarker discriminating low grade and high grade (CIN2+) dysplasia. P16, proliferation associated markers (Ki67, MCM2, Stathmin), and tumor markers (ALDH1A1, BIRC5, hTERT) contributed to detection and differentiation of dysplastic stages. Accuracy by ROC analysis to detect CIN3+ from the initial screening sample was 90%.
Conclusions
Multiplexed mRNA quantification of viral and cellular biomarkers by QuantiGene 2.0 Plex assay detects HPV infection and dysplasia with high accuracy. The assay could be used as a triage to colposcopy after primary HPV screening. The assay procedure is simple and robust and maybe used in LMIC settings to reduce further triage and avoid overreferral.