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Rabasa J, Bradbury M, Sanchez-Iglesias JL, Guerrero D, Forcada C, Alcalde A, Pérez-Benavente A, Cabrera S, Ramon-Cajal S, Hernandez J, Dinares C, García A, Centeno C, Gil-Moreno A. Evaluation of the intraoperative human papillomavirus test as a marker of early cure at 12 months after electrosurgical excision procedure in women with cervical high-grade squamous intraepithelial lesion: a prospective cohort study. BJOG 2019; 127:99-105. [PMID: 31502397 DOI: 10.1111/1471-0528.15932] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of high-grade squamous intraepithelial lesion (HSIL) to predict treatment failure. DESIGN Prospective cohort study. SETTING Barcelona, Spain. POPULATION A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure (LEEP). METHODS After LEEP, an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV2 technique. The IOP-HPV test was compared with HPV test at 6 months and with surgical margins. MAIN OUTCOME MEASURE Treatment failure. RESULTS Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP-HPV test, a positive 6-month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP-HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%. CONCLUSION Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high-risk patients. TWEETABLE ABSTRACT IOP-HPV test accurately predicts treatment failure in women with CIN 2/3.
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Affiliation(s)
- J Rabasa
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - M Bradbury
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - J L Sanchez-Iglesias
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - D Guerrero
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Forcada
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Alcalde
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Pérez-Benavente
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - S Cabrera
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - S Ramon-Cajal
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain.,Spanish Biomedical Research Network Centre In Oncology (CIBERONC), Barcelona, Spain
| | - J Hernandez
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain.,Spanish Biomedical Research Network Centre In Oncology (CIBERONC), Barcelona, Spain
| | - C Dinares
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A García
- Department of Pathology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Centeno
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain
| | - A Gil-Moreno
- Department of Gynaecology and Obstetrics, Vall d'Hebron University Hospital, Barcelona, Spain.,Spanish Biomedical Research Network Centre In Oncology (CIBERONC), Barcelona, Spain
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Campoy I, Lanau L, Altadill T, Sequeiros T, Cabrera S, Cubo-Abert M, Pérez-Benavente A, Garcia A, Borrós S, Santamaria A, Ponce J, Matias-Guiu X, Reventós J, Gil-Moreno A, Rigau M, Colas E. Exosome-like vesicles in uterine aspirates: a comparison of ultracentrifugation-based isolation protocols. J Transl Med 2016; 14:180. [PMID: 27317346 PMCID: PMC4912787 DOI: 10.1186/s12967-016-0935-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 06/02/2016] [Indexed: 01/05/2023] Open
Abstract
Background Uterine aspirates are used in the diagnostic process of endometrial disorders, yet further applications could emerge if its complex milieu was simplified. Exosome-like vesicles isolated from uterine aspirates could become an attractive source of biomarkers, but there is a need to standardize isolation protocols. The objective of the study was to determine whether exosome-like vesicles exist in the fluid fraction of uterine aspirates and to compare protocols for their isolation, characterization, and analysis. Methods We collected uterine aspirates from 39 pre-menopausal women suffering from benign gynecological diseases. The fluid fraction of 27 of those aspirates were pooled and split into equal volumes to evaluate three differential centrifugation-based procedures: (1) a standard protocol, (2) a filtration protocol, and (3) a sucrose cushion protocol. Characterization of isolated vesicles was assessed by electron microscopy, nanoparticle tracking analysis and immunoblot. Specifically for RNA material, we evaluate the effect of sonication and RNase A treatment at different steps of the protocol. We finally confirmed the efficiency of the selected methods in non-pooled samples. Results All protocols were useful to isolate exosome-like vesicles. However, the Standard procedure was the best performing protocol to isolate exosome-like vesicles from uterine aspirates: nanoparticle tracking analysis revealed a higher concentration of vesicles with a mode of 135 ± 5 nm, and immunoblot showed a higher expression of exosome-related markers (CD9, CD63, and CD81) thus verifying an enrichment in this type of vesicles. RNA contained in exosome-like vesicles was successfully extracted with no sonication treatment and exogenous nucleic acids digestion with RNaseA, allowing the analysis of the specific inner cargo by Real-Time qPCR. Conclusion We confirmed the existence of exosome-like vesicles in the fluid fraction of uterine aspirates. They were successfully isolated by differential centrifugation giving sufficient proteomic and transcriptomic material for further analyses. The Standard protocol was the best performing procedure since the other two tested protocols did not ameliorate neither yield nor purity of exosome-like vesicles. This study contributes to establishing the basis for future comparative studies to foster the field of biomarker research in gynecology. Electronic supplementary material The online version of this article (doi:10.1186/s12967-016-0935-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Irene Campoy
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lucia Lanau
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tatiana Altadill
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tamara Sequeiros
- Biomedical Research Group in Urology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Silvia Cabrera
- Department of Gynecology, Vall Hebron University Hospital, Barcelona, Spain
| | | | | | - Angel Garcia
- Pathology Department, Vall Hebron University Hospital, Barcelona, Spain
| | - Salvador Borrós
- Grup d'Enginyeria de Materials (GEMAT), Institut Químic de Sarrià, Universitat Ramon Llull, Barcelona, Spain
| | - Anna Santamaria
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Ponce
- Department of Gynecology, Bellvitge Teaching Hospital, Barcelona, Spain
| | - Xavier Matias-Guiu
- Department of Pathology and Molecular Genetics/Oncologic Pathology Group, University Hospital Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain
| | - Jaume Reventós
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Barcelona, Spain.,Basic Sciences Department, International University of Catalonia, Barcelona, Spain
| | - Antonio Gil-Moreno
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Gynecology, Vall Hebron University Hospital, Barcelona, Spain
| | - Marina Rigau
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eva Colas
- Biomedical Research Group in Gynecology, Vall Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain. .,Department of Pathology and Molecular Genetics/Oncologic Pathology Group, University Hospital Arnau de Vilanova, University of Lleida, IRBLleida, Lleida, Spain.
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Gil-Moreno A, Magrina JF, Pérez-Benavente A, Díaz-Feijoo B, Sánchez-Iglesias JL, García A, Cabrera-Díaz S, Puig O, Martínez-Gómez X, Xercavins J. Location of aortic node metastases in locally advanced cervical cancer. Gynecol Oncol 2012; 125:312-4. [PMID: 22333995 DOI: 10.1016/j.ygyno.2012.02.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 02/02/2012] [Accepted: 02/04/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND To assess the location of aortic node metastasis in patients with locally advanced cervical cancer undergoing extraperitoneal aortic lymphadenectomy to define the extent of the aortic lymphadenectomy. MATERIAL AND METHODS Between August 2001 and December 2010, 100 consecutive patients with primary locally advanced cervical cancer underwent extraperitoneal laparoscopic aortic and common iliac lymphadenectomy. The location of aortic node metastases, inframesenteric or infrarenal was noted. RESULTS The mean number±standard deviation (SD) of aortic nodes removed was 15.9 ± 7.8 (range 4-62). The mean number ± SD of inframesenteric (including common iliac) nodes removed was 8.8 ± 4.5 (range 2-41) and the mean number ± SD of infrarenal nodes removed was 7.8 ± 4.1 (range 2-21). Positive aortic nodes were observed in 16 patients, and in 5 (31.2%) of them the infrarenal nodes were the only nodes involved, with negative inframesenteric nodes. CONCLUSION Inframesenteric aortic nodes are negative in the presence of positive infrarenal nodes in about one third of patients with locally advanced cervical cancer and aortic metastases.
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Affiliation(s)
- A Gil-Moreno
- Unit of Gynecologic Oncology, Department of Obstetrics and Gynecology, Hospital Materno-Infantil Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
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