Dysplasia and cervical cancer: current diagnostic possibilities

Czech version

Authors: L. Rotter ^1,2; P. Rotterová ³; I. Kinkorová Luňáčková ³; J. Kašpírková ³; M. Michal ³; R. Hudeček ²
Authors‘ workplace: Reprofit International s. r. o., Brno ¹; Gynekologicko-porodnická klinika LF MU a FN, Brno, přednosta prof. MUDr. P. Ventruba, DrSc., MBA ²; Bioptická laboratoř, s. r. o., Plzeň ³
Published in: Ceska Gynekol 2014; 79(4): 314-320

Overview

Objective:
To review current methods in the diagnosis of dysplasia and cervical cancer.

Design:
Review article.

Setting:
Reprofit International Ltd., Brno; Department of Gynecology and Obstetrics, University Hospital and Faculty of Medicine, Masaryk University, Brno; Biopticka laborator Ltd., Pilsen.

Methods and results:
Nowadays, there are non-invasive methods for more accurate and timely detection of uterine cervix lesions. Digital images of the uterine cervix can be analysed by a computer for characteristic features and colour patterns, which may enhance the objectivity of the colposcopic examination. Digital image processing technology and biomarkers detection (p16/Ki-67) are useful in liquid based cytology (LBC). At the molecular genetic level different tests are used to detect deoxy- or ribonucleic acid (DNA, RNA) of high-risk types of human papillomavirus (HR HPV). The introduction of HPV testing in screening procedures in the Czech Republic will further in-crease the sensitivity of screening. However, the most specific identification of cervical high-grade lesions appears to be an mRNA detection of oncogenes E6 and E7. The advanced method for the assessment of cervical lesion progress in HR HPV positive women is to determine the methylation of tumor supressor genes that normally prevents the cancer growth.

Conclusion:
Screening programs, inviting women to direct preventive gynecological examinations by health insurance, but also efficient utilization of available methods could lead to early detections of cervical dysplasias.

Keywords:
cervical dysplasia and cancer, SIL, colposcopy, LBC, HPV, methylation, mRNA

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