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  1. Article ; Online: Cleavage of the urokinase receptor (uPAR) on oral cancer cells: regulation by transforming growth factor - β1 (TGF-β1) and potential effects on migration and invasion.

    Magnussen, Synnove Norvoll / Hadler-Olsen, Elin / Costea, Daniela Elena / Berg, Eli / Jacobsen, Cristiane Cavalcanti / Mortensen, Bente / Salo, Tuula / Martinez-Zubiaurre, Inigo / Winberg, Jan-Olof / Uhlin-Hansen, Lars / Svineng, Gunbjorg

    BMC cancer

    2017  Volume 17, Issue 1, Page(s) 350

    Abstract: Background: Urokinase plasminogen activator (uPA) receptor (uPAR) is up-regulated at the invasive tumour front of human oral squamous cell carcinoma (OSCC), indicating a role for uPAR in tumour progression. We previously observed elevated expression of ... ...

    Abstract Background: Urokinase plasminogen activator (uPA) receptor (uPAR) is up-regulated at the invasive tumour front of human oral squamous cell carcinoma (OSCC), indicating a role for uPAR in tumour progression. We previously observed elevated expression of uPAR at the tumour-stroma interface in a mouse model for OSCC, which was associated with increased proteolytic activity. The tumour microenvironment regulated uPAR expression, as well as its glycosylation and cleavage. Both full-length- and cleaved uPAR (uPAR (II-III)) are involved in highly regulated processes such as cell signalling, proliferation, migration, stem cell mobilization and invasion. The aim of the current study was to analyse tumour associated factors and their effect on uPAR cleavage, and the potential implications for cell proliferation, migration and invasion.
    Methods: Mouse uPAR was stably overexpressed in the mouse OSCC cell line AT84. The ratio of full-length versus cleaved uPAR as analysed by Western blotting and its regulation was assessed by addition of different protease inhibitors and transforming growth factor - β1 (TGF-β1). The role of uPAR cleavage in cell proliferation and migration was analysed using real-time cell analysis and invasion was assessed using the myoma invasion model.
    Results: We found that when uPAR was overexpressed a proportion of the receptor was cleaved, thus the cells presented both full-length uPAR and uPAR (II-III). Cleavage was mainly performed by serine proteases and urokinase plasminogen activator (uPA) in particular. When the OSCC cells were stimulated with TGF-β1, the production of the uPA inhibitor PAI-1 was increased, resulting in a reduction of uPAR cleavage. By inhibiting cleavage of uPAR, cell migration was reduced, and by inhibiting uPA activity, invasion was reduced. We could also show that medium containing soluble uPAR (suPAR), and cleaved soluble uPAR (suPAR (II-III)), induced migration in OSCC cells with low endogenous levels of uPAR.
    Conclusions: These results show that soluble factors in the tumour microenvironment, such as TGF-β1, PAI-1 and uPA, can influence the ratio of full length and uPAR (II-III) and thereby potentially effect cell migration and invasion. Resolving how uPAR cleavage is controlled is therefore vital for understanding how OSCC progresses and potentially provides new targets for therapy.
    Language English
    Publishing date 2017-05-19
    Publishing country England
    Document type Journal Article
    ISSN 1471-2407
    ISSN (online) 1471-2407
    DOI 10.1186/s12885-017-3349-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Immunity and autoimmunity to dsDNA and chromatin--the role of immunogenic DNA-binding proteins and nuclease deficiencies.

    Rekvig, Ole Petter / Mortensen, Elin Synnøve

    Autoimmunity

    2012  Volume 45, Issue 8, Page(s) 588–592

    Abstract: Loss of immunological tolerance results in autoimmunity and may finally end in autoimmune disorders. For an autoimmune response against chromatin, autologous chromatin (nucleosomes) is assumed to activate both chromatin-specific B and T cells with a ... ...

    Abstract Loss of immunological tolerance results in autoimmunity and may finally end in autoimmune disorders. For an autoimmune response against chromatin, autologous chromatin (nucleosomes) is assumed to activate both chromatin-specific B and T cells with a resulting anti-chromatin antibody response. As only fragmental elements of this process have been described, we do not have the full insight to justify this model in vivo. Early experimental immunization with methylated bovine serum albumin-DNA complexes elicited antibodies to various forms of synthetic ssDNA/dsDNA, but notably not to mammalian dsDNA. Thus, for a long time with intense research, the general result was that all forms of ssDNA and dsDNA, but mammalian B helical DNA, had an immunogenic potential. Summarizing these results, a preliminary conclusion was settled, saying that mammalian dsDNA was not immunogenic while other forms of DNA were really immunogenic in the situation where they were in complex with proteins. Recent studies have focused on nuclease deficiencies as a condition where chromatin may be presented to the immune system in an immunogenic form. However, although such deficiencies may provide information as to how chromatin may be exposed and targeted by relevant antibodies, data demonstrate that nuclease deficiencies is not in general correlated with autoimmunity to components of chromatin. This review discusses these topics, and provides information that may explain processes that account for anti-dsDNA antibody responses in vivo.
    MeSH term(s) Animals ; Antibodies, Antinuclear/immunology ; Autoimmunity ; Chromatin/immunology ; DNA/immunology ; DNA-Binding Proteins/immunology ; Deoxyribonucleases/deficiency ; Deoxyribonucleases/metabolism ; Endodeoxyribonucleases/deficiency ; Endodeoxyribonucleases/metabolism ; Humans ; Lupus Nephritis/immunology
    Chemical Substances Antibodies, Antinuclear ; Chromatin ; DNA-Binding Proteins ; DNA (9007-49-2) ; Deoxyribonucleases (EC 3.1.-) ; Endodeoxyribonucleases (EC 3.1.-)
    Language English
    Publishing date 2012-12
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1025450-x
    ISSN 1607-842X ; 0891-6934
    ISSN (online) 1607-842X
    ISSN 0891-6934
    DOI 10.3109/08916934.2012.719954
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Nephritogenic potential of anti-DNA antibodies against necrotic nucleosomes.

    Mortensen, Elin Synnøve / Rekvig, Ole Petter

    Journal of the American Society of Nephrology : JASN

    2009  Volume 20, Issue 4, Page(s) 696–704

    Abstract: Systemic lupus erythematosus is an inflammatory autoimmune syndrome of unknown cause. Kidney disease is a central and serious complication in this syndrome. Deposition of chromatin-containing immune complexes within glomerular membranes is considered a ... ...

    Abstract Systemic lupus erythematosus is an inflammatory autoimmune syndrome of unknown cause. Kidney disease is a central and serious complication in this syndrome. Deposition of chromatin-containing immune complexes within glomerular membranes is considered a key event in the pathogenesis of lupus nephritis. One set of autoantibodies that participate in these complexes is directed against components of chromatin, particularly against double-stranded DNA (dsDNA). Matzinger's danger model implicates chromatin fragments as both inducers and glomerular targets for nephritogenic anti-dsDNA and anti-nucleosome antibodies. In context of this model, apoptosis, secondary necrosis, and exposure of chromatin fragments may causally trigger autoimmunity and subsequent lupus nephritis. The exposure of glomerular basement membrane-associated extracellular chromatin depends on an observed acquired downregulation of renal DNase1 transcription and loss of nuclease activity preceding development of severe nephritis; this downregulation would result in reduced fragmentation and clearance of chromatin fragments. These fragments bind glomerular basement membrane structures with high affinity. In addition, exposed chromatin fragments contain structures that stimulate the innate immune system through Toll-like receptors and the adaptive immune system to produce affinity-maturated pathogenic anti-chromatin and anti-dsDNA antibodies that are central to the development of lupus nephritis.
    MeSH term(s) Animals ; Antibodies, Antinuclear/toxicity ; Disease Models, Animal ; Humans ; Inflammation/immunology ; Kidney Diseases/etiology ; Kidney Diseases/immunology ; Kidney Glomerulus/immunology ; Lupus Erythematosus, Systemic/immunology ; Lupus Nephritis/immunology ; Lupus Nephritis/pathology ; Mice ; Mice, Inbred Strains ; Proteinuria/immunology
    Chemical Substances Antibodies, Antinuclear
    Language English
    Publishing date 2009-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1085942-1
    ISSN 1533-3450 ; 1046-6673
    ISSN (online) 1533-3450
    ISSN 1046-6673
    DOI 10.1681/ASN.2008010112
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Primary cervical cancer screening with an HPV mRNA test: a prospective cohort study.

    Sørbye, Sveinung Wergeland / Fismen, Silje / Gutteberg, Tore Jarl / Mortensen, Elin Synnøve / Skjeldestad, Finn Egil

    BMJ open

    2016  Volume 6, Issue 8, Page(s) e011981

    Abstract: Objectives: To assess the performance of a 5-type human papillomavirus (HPV) messenger RNA (mRNA) test in primary screening within the framework of the Norwegian population-based screening programme.: Design: Nationwide register-based cohort study.!## ...

    Abstract Objectives: To assess the performance of a 5-type human papillomavirus (HPV) messenger RNA (mRNA) test in primary screening within the framework of the Norwegian population-based screening programme.
    Design: Nationwide register-based cohort study.
    Setting: In 2003-2004, general practitioners and gynaecologists recruited 18 852 women for participation in a primary screening study with a 5-type HPV mRNA test.
    Participants: After excluding women with a history of abnormal smears and with cervical intraepithelial neoplasia grade 2 (CIN2+) before or until 3 months after screening, 11 220 women aged 25-69 years were eligible for study participation. The Norwegian Cancer Registry completed follow-up of CIN2+ through 31 December 2009.
    Interventions: Follow-up according to the algorithm for cytology outcomes in the population-based Norwegian Cervical Cancer Screening Programme.
    Main outcome measures: We estimated cumulative incidence of CIN grade 3 or worse (CIN3+) 72 months after the 5-type HPV mRNA test.
    Results: 3.6% of the women were HPV mRNA-positive at baseline. The overall cumulative rate of CIN3+ was 1.3% (95% CI 1.1% to 1.5%) through 72 months of follow-up, 2.3% for women aged 25-33 years (n=3277) and 0.9% for women aged 34-69 years (n=7943). Cumulative CIN3+ rates by baseline status for HPV mRNA-positive and mRNA-negative women aged 25-33 years were 22.2% (95% CI 14.5% to 29.8%) and 0.9% (95% CI 0.4% to 1.4%), respectively, and 16.6% (95% CI 10.7% to 22.5%) and 0.5% (95% CI 0.4% to 0.7%), respectively, in women aged 34-69 years.
    Conclusions: The present cumulative incidence of CIN3+ is similar to rates reported in screening studies via HPV DNA tests. Owing to differences in biological rationale and test characteristics, there is a trade-off between sensitivity and specificity that must be balanced when decisions on HPV tests in primary screening are taken. HPV mRNA testing may be used as primary screening for women aged 25-33 years and 34-69 years.
    MeSH term(s) Adult ; Aged ; Cervical Intraepithelial Neoplasia/diagnosis ; Cervical Intraepithelial Neoplasia/epidemiology ; Cervical Intraepithelial Neoplasia/virology ; Early Detection of Cancer/methods ; Female ; Humans ; Incidence ; Mass Screening/methods ; Middle Aged ; Norway/epidemiology ; Papillomaviridae/genetics ; Papillomavirus Infections/diagnosis ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/virology ; Prospective Studies ; RNA, Messenger/analysis ; RNA, Viral/analysis ; Sensitivity and Specificity ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/virology ; Vaginal Smears
    Chemical Substances RNA, Messenger ; RNA, Viral
    Language English
    Publishing date 2016-08-11
    Publishing country England
    Document type Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2747269-3
    ISSN 2044-6055 ; 2044-6055 ; 2053-3624
    ISSN (online) 2044-6055
    ISSN 2044-6055 ; 2053-3624
    DOI 10.1136/bmjopen-2016-011981
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The expression of the long NEAT1_2 isoform is associated with human epidermal growth factor receptor 2-positive breast cancers.

    Knutsen, Erik / Lellahi, Seyed Mohammad / Aure, Miriam Ragle / Nord, Silje / Fismen, Silje / Larsen, Kenneth Bowitz / Gabriel, Marta Tellez / Hedberg, Annica / Bjørklund, Sunniva Stordal / Bofin, Anna Mary / Mælandsmo, Gunhild Mari / Sørlie, Therese / Mortensen, Elin Synnøve / Perander, Maria

    Scientific reports

    2020  Volume 10, Issue 1, Page(s) 1277

    Abstract: The long non-coding RNA NEAT1 locus is transcribed into two overlapping isoforms, NEAT1_1 and NEAT1_2, of which the latter is essential for the assembly of nuclear paraspeckles. NEAT1 is abnormally expressed in a wide variety of human cancers. Emerging ... ...

    Abstract The long non-coding RNA NEAT1 locus is transcribed into two overlapping isoforms, NEAT1_1 and NEAT1_2, of which the latter is essential for the assembly of nuclear paraspeckles. NEAT1 is abnormally expressed in a wide variety of human cancers. Emerging evidence suggests that the two isoforms have distinct functions in gene expression regulation, and recently it was shown that NEAT1_2, but not NEAT1_1, expression predicts poor clinical outcome in cancer. Here, we report that NEAT1_2 expression correlates with HER2-positive breast cancers and high-grade disease. We provide evidence that NEAT1_1 and NEAT1_2 have distinct expression pattern among different intrinsic breast cancer subtypes. Finally, we show that NEAT1_2 expression and paraspeckle formation increase upon lactation in humans, confirming what has previously been demonstrated in mice.
    MeSH term(s) Breast Neoplasms/metabolism ; Breast Neoplasms/pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; MCF-7 Cells ; RNA, Long Noncoding/biosynthesis ; RNA, Neoplasm/biosynthesis
    Chemical Substances MALAT1 long non-coding RNA, human ; NEAT1 long non-coding RNA, human ; RNA, Long Noncoding ; RNA, Neoplasm
    Language English
    Publishing date 2020-01-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-020-57759-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Chromatin as a target antigen in human and murine lupus nephritis.

    Hedberg, Annica / Mortensen, Elin Synnøve / Rekvig, Ole Petter

    Arthritis research & therapy

    2011  Volume 13, Issue 2, Page(s) 214

    Abstract: The present review focuses on pathogenic molecular and transcriptional events in patients with lupus nephritis. These factors are renal DNaseI, exposed chromatin fragments and the corresponding chromatin-reactive autoantibodies. Lupus nephritis is the ... ...

    Abstract The present review focuses on pathogenic molecular and transcriptional events in patients with lupus nephritis. These factors are renal DNaseI, exposed chromatin fragments and the corresponding chromatin-reactive autoantibodies. Lupus nephritis is the most serious complication in human systemic lupus erythematosus, and is characterised by deposition of chromatin fragment-IgG complexes in the mesangial matrix and glomerular basement membranes. The latter deposition defines end-stage disease. This event is stringently linked to a renal-restricted shutdown of expression of the DNaseI gene, as determined by loss of DNaseI mRNA level and DNaseI enzyme activity. The major aim of the present review is to generate new therapeutic strategies based on new insight into the disease pathogenesis.
    MeSH term(s) Animals ; Antibodies, Antinuclear/immunology ; Autoantigens/immunology ; Chromatin/immunology ; Glomerular Basement Membrane/immunology ; Humans ; Lupus Nephritis/immunology ; Mice
    Chemical Substances Antibodies, Antinuclear ; Autoantigens ; Chromatin
    Language English
    Publishing date 2011-04-18
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2107602-9
    ISSN 1478-6362 ; 1478-6354
    ISSN (online) 1478-6362
    ISSN 1478-6354
    DOI 10.1186/ar3281
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: HPV mRNA is more specific than HPV DNA in triage of women with minor cervical lesions.

    Sveinung Wergeland Sørbye / Silje Fismen / Tore Jarl Gutteberg / Elin Synnøve Mortensen / Finn Egil Skjeldestad

    PLoS ONE, Vol 9, Iss 11, p e

    2014  Volume 112934

    Abstract: In Norway, repeat cytology and HPV testing comprise delayed triage of women with minor cytological lesions. The objective of this study was to evaluate HPV DNA and HPV mRNA testing in triage of women with an ASC-US/LSIL diagnosis.We used repeat cytology, ...

    Abstract In Norway, repeat cytology and HPV testing comprise delayed triage of women with minor cytological lesions. The objective of this study was to evaluate HPV DNA and HPV mRNA testing in triage of women with an ASC-US/LSIL diagnosis.We used repeat cytology, HPV DNA testing (Cobas 4800) and HPV mRNA testing (PreTect HPV-Proofer) to follow up 311 women aged 25-69 years with ASC-US/LSIL index cytology.Of 311 women scheduled for secondary screening, 30 women (9.6%) had ASC-H/HSIL cytology at triage and 281 women (90.4%) had ASC-US/LSIL or normal cytology. The HPV DNA test was positive in 92 (32.7%) of 281 instances, and 37 (13.2%) were mRNA positive. Of the 132 women with repeated ASC-US/LSIL, we received biopsies from 97.0% (65/67) of the DNA-positive and 92.9% (26/28) of the mRNA-positive cases. The positive predictive values for CIN2+ were 21.5% (14/65) for DNA positive and 34.6% (9/26) for mRNA positive (ns). The odds ratio for being referred to colposcopy in DNA-positive cases were 2.8 times (95% CI: 1.8-4.6) higher that of mRNA-positive cases. Compared to the mRNA test, the DNA test detected four more cases of CIN2 and one case of CIN3.The higher positivity rate of the DNA test in triage leads to higher referral rate for colposcopy and biopsy, and subsequent additional follow-up of negative biopsies. By following mRNA-negative women who had ASC-US/LSIL at triage with cytology, the additional cases of CIN2+ gained in DNA screening can be discovered. Our study indicates that in triage of repeated ASC-US/LSIL, HPV mRNA testing is more specific and is more relevant in clinical use than an HPV DNA test.
    Keywords Medicine ; R ; Science ; Q
    Subject code 610
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: HPV mRNA is more specific than HPV DNA in triage of women with minor cervical lesions.

    Sørbye, Sveinung Wergeland / Fismen, Silje / Gutteberg, Tore Jarl / Mortensen, Elin Synnøve / Skjeldestad, Finn Egil

    PloS one

    2014  Volume 9, Issue 11, Page(s) e112934

    Abstract: Background: In Norway, repeat cytology and HPV testing comprise delayed triage of women with minor cytological lesions. The objective of this study was to evaluate HPV DNA and HPV mRNA testing in triage of women with an ASC-US/LSIL diagnosis.: ... ...

    Abstract Background: In Norway, repeat cytology and HPV testing comprise delayed triage of women with minor cytological lesions. The objective of this study was to evaluate HPV DNA and HPV mRNA testing in triage of women with an ASC-US/LSIL diagnosis.
    Materials and methods: We used repeat cytology, HPV DNA testing (Cobas 4800) and HPV mRNA testing (PreTect HPV-Proofer) to follow up 311 women aged 25-69 years with ASC-US/LSIL index cytology.
    Results: Of 311 women scheduled for secondary screening, 30 women (9.6%) had ASC-H/HSIL cytology at triage and 281 women (90.4%) had ASC-US/LSIL or normal cytology. The HPV DNA test was positive in 92 (32.7%) of 281 instances, and 37 (13.2%) were mRNA positive. Of the 132 women with repeated ASC-US/LSIL, we received biopsies from 97.0% (65/67) of the DNA-positive and 92.9% (26/28) of the mRNA-positive cases. The positive predictive values for CIN2+ were 21.5% (14/65) for DNA positive and 34.6% (9/26) for mRNA positive (ns). The odds ratio for being referred to colposcopy in DNA-positive cases were 2.8 times (95% CI: 1.8-4.6) higher that of mRNA-positive cases. Compared to the mRNA test, the DNA test detected four more cases of CIN2 and one case of CIN3.
    Conclusions: The higher positivity rate of the DNA test in triage leads to higher referral rate for colposcopy and biopsy, and subsequent additional follow-up of negative biopsies. By following mRNA-negative women who had ASC-US/LSIL at triage with cytology, the additional cases of CIN2+ gained in DNA screening can be discovered. Our study indicates that in triage of repeated ASC-US/LSIL, HPV mRNA testing is more specific and is more relevant in clinical use than an HPV DNA test.
    MeSH term(s) Adult ; Aged ; Atypical Squamous Cells of the Cervix/pathology ; DNA, Viral/genetics ; Female ; Humans ; Middle Aged ; Norway ; Papillomaviridae/genetics ; RNA, Messenger/genetics ; Squamous Intraepithelial Lesions of the Cervix/diagnosis ; Squamous Intraepithelial Lesions of the Cervix/pathology ; Statistics, Nonparametric ; Survival Analysis ; Triage/methods
    Chemical Substances DNA, Viral ; RNA, Messenger
    Language English
    Publishing date 2014
    Publishing country United States
    Document type Comparative Study ; Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0112934
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Triage of women with minor cervical lesions

    Sveinung Wergeland Sørbye / Silje Fismen / Tore Gutteberg / Elin Synnøve Mortensen

    PLoS ONE, Vol 5, Iss 9, p e

    data suggesting a "test and treat" approach for HPV E6/E7 mRNA testing.

    2010  Volume 12724

    Abstract: BACKGROUND: Human papillomavirus (HPV) testing is included in the cervical cancer screening program in the triage of women with equivocal (ASC-US) or low-grade (LSIL) cytological lesions. These women have an increased risk for developing high grade ... ...

    Abstract BACKGROUND: Human papillomavirus (HPV) testing is included in the cervical cancer screening program in the triage of women with equivocal (ASC-US) or low-grade (LSIL) cytological lesions. These women have an increased risk for developing high grade dysplasia and cancer (CIN2+) compared to women with normal cytology. However, in order to avoid unnecessary follow-up, as well as overtreatment, a high positive predictive value (PPV) of the triage test is important. METHODOLOGY/PRINCIPAL FINDINGS: The HPV test PreTect HPV-Proofer, detecting E6/E7 mRNA from the HPV types 16, 18, 31, 33 and 45, is used as triage test together with repeat cytology. PPV data for HPV E6/E7 mRNA testing during the period from January 2006 up to June 2009 are reported. In total, 406 of 2099 women (19.3%) had a positive HPV test result. Of the women with a positive test result and with a histological diagnosis (n = 347), 243 women had histological high-grade dysplasia or cancer (CIN2+), giving a PPV of 70.0% (95% confidence interval [CI], 65.2%-74.8%). For HPV 16 or HPV 33 positive women above 40 years of age, the PPV was 83.7% (95% CI, 73.3%-94.0%) and 84.6% (95% CI, 65.0%-100.0%) respectively. The PPV of test positive women with HSIL cytology was 94.2% (95% CI, 88.7%-99.7%). CONCLUSIONS: When the result in triage is HPV mRNA positive, our data suggest direct treatment for women above 40 years of age or for women with a concurrent cytological HSIL diagnosis, contributing to better clinical safety for these women. In addition, by decreasing the time to treatment, thereby reducing the number of recalls, the patient management algorithm will be considerably improved, in turn reducing follow-up costs as well as unnecessary psychological stress among patients.
    Keywords Medicine ; R ; Science ; Q
    Subject code 150
    Language English
    Publishing date 2010-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Triage of women with minor cervical lesions: data suggesting a "test and treat" approach for HPV E6/E7 mRNA testing.

    Sørbye, Sveinung Wergeland / Fismen, Silje / Gutteberg, Tore / Mortensen, Elin Synnøve

    PloS one

    2010  Volume 5, Issue 9, Page(s) e12724

    Abstract: Background: Human papillomavirus (HPV) testing is included in the cervical cancer screening program in the triage of women with equivocal (ASC-US) or low-grade (LSIL) cytological lesions. These women have an increased risk for developing high grade ... ...

    Abstract Background: Human papillomavirus (HPV) testing is included in the cervical cancer screening program in the triage of women with equivocal (ASC-US) or low-grade (LSIL) cytological lesions. These women have an increased risk for developing high grade dysplasia and cancer (CIN2+) compared to women with normal cytology. However, in order to avoid unnecessary follow-up, as well as overtreatment, a high positive predictive value (PPV) of the triage test is important.
    Methodology/principal findings: The HPV test PreTect HPV-Proofer, detecting E6/E7 mRNA from the HPV types 16, 18, 31, 33 and 45, is used as triage test together with repeat cytology. PPV data for HPV E6/E7 mRNA testing during the period from January 2006 up to June 2009 are reported. In total, 406 of 2099 women (19.3%) had a positive HPV test result. Of the women with a positive test result and with a histological diagnosis (n = 347), 243 women had histological high-grade dysplasia or cancer (CIN2+), giving a PPV of 70.0% (95% confidence interval [CI], 65.2%-74.8%). For HPV 16 or HPV 33 positive women above 40 years of age, the PPV was 83.7% (95% CI, 73.3%-94.0%) and 84.6% (95% CI, 65.0%-100.0%) respectively. The PPV of test positive women with HSIL cytology was 94.2% (95% CI, 88.7%-99.7%).
    Conclusions: When the result in triage is HPV mRNA positive, our data suggest direct treatment for women above 40 years of age or for women with a concurrent cytological HSIL diagnosis, contributing to better clinical safety for these women. In addition, by decreasing the time to treatment, thereby reducing the number of recalls, the patient management algorithm will be considerably improved, in turn reducing follow-up costs as well as unnecessary psychological stress among patients.
    MeSH term(s) Adult ; Aged ; Alphapapillomavirus/genetics ; Alphapapillomavirus/isolation & purification ; Female ; Humans ; Middle Aged ; Oncogene Proteins, Viral/genetics ; Papillomavirus Infections/diagnosis ; Papillomavirus Infections/pathology ; Papillomavirus Infections/therapy ; Papillomavirus Infections/virology ; RNA, Messenger/genetics ; RNA, Viral/genetics ; Triage/methods ; Uterine Cervical Neoplasms/diagnosis ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/therapy ; Uterine Cervical Neoplasms/virology ; Vaginal Smears
    Chemical Substances Oncogene Proteins, Viral ; RNA, Messenger ; RNA, Viral
    Language English
    Publishing date 2010-09-13
    Publishing country United States
    Document type Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0012724
    Database MEDical Literature Analysis and Retrieval System OnLINE

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