From Papanicolaou to Papillomaviruses: Evolving Challenges in Cervical Cancer Screening in the Era of Human Papillomavirus Vaccination
Menée auprès de 27 349 femmes âgées de 18 ans ou plus, cette étude européenne, évalue, par rapport au test de Papanicolaou et au test HPV, la sensibilité et la spécificité d'un test basé sur l'expression conjointe des protéines p16 et ki-67 pour détecter précocement une lésion pré-cancéreuse de haut grade du col utérin (CIN2+)
February 2012 marked the 50th anniversary of the death of George Papanicolaou, the inventor of the Pap test for cervical cancer screening. Pap test screening has contributed to sharp reductions in cervical cancer incidence and mortality throughout the developed world (1–5). Despite the success of the Pap test, recognition that it suffers from inadequate single-test sensitivity and frequent equivocal results has prompted searches for newer screening methods.
Demonstration that carcinogenic human papillomavirus (HPV) infections are the cause of nearly all cervical cancer has led to the use of HPV DNA testing for screening. A negative HPV DNA test provides strong reassurance that cervical cancer risk is low and will remain so for many years (6). However, the clinical significance of a positive test is less clear, especially at young ages when most HPV infections are extremely common and self-limited. In this issue of the Journal, Ikenberg and colleagues present results from the Primary, ASC-US, LSIL Marker Study (PALMS), a multicenter investigation of the performance of a dual label p16/Ki-67 immunocytology assay (7). The dual stain assesses molecular changes downstream of HPV infection by assessing coexpression of p16, a marker of transforming HPV infection, and Ki-67, a marker of proliferation, within the same epithelial cell, independent of morphological assessment...
Journal of the National Cancer Institute , éditorial en libre accès, 2013