Conference Proceeding

Cervical cancer screening- new insights

Dr. K. Sujathan ,
Centre for Advanced Computing, CSIR-NIIST, Trivandrum, Kerala, India

Despite drastic decrease in the incidence of cervical cancer in countries that have adopted Pap smear screening programme, it is still one of the most commonly diagnosed cancers in women with 529,800 new cases worldwide annually.

Dr. K. Sujathan carried out his post doctoral degree in Faculty of Science, Annamalai university, India. Later he started working as a Cytotechnologist, Regional Cancer Center, Trivandrum, India. He has many honors and awards. Presently he is working as a Associate Professor, Division of Cancer Research, Regional Cancer Center, Trivandrum, Kerala, India.

Despite drastic decrease in the incidence of cervical cancer in countries that have adopted Pap smear screening programme, it is still one of the most commonly diagnosed cancers in women with 529,800 new cases worldwide annually. Recent reports suggest the limitations of the Pap smear including low sensitivity, high false negative rates, and inter-observer variability. These limitations have forced many to reconsider the significance of cytology as a primary screening test particularly when compared to Human Papilloma Virus (HPV) testing. Hence Pap smear plus HPV DNA test and vaccination against high risk HPV is prevalent in the Developed world. India contributes one fifth of the global burden of cervical cancer. Screening programes with Pap smear and/ HPV DNA test couldn’t be implemented in countries like India, China etc. due to various constrains. Interest has therefore been focused on identification of low cost molecular markers to define effective screening strategies. It is now widely accepted that p16INK4A as a sensitive and specific marker of squamous and glandular dysplastic cells of the cervix, and is considered as a valuable adjunctive test in diagnosis and screening. Several studies have highlighted potential use of MCM5, MCM2 and cdc6 in the identification and/or diagnosis of a variety of dysplastic and neoplastic conditions. We have compared the expression pattern of p16INK4A, MCM2, MCM5 and CDC6 to assess their potential as markers of dysplastic squamous and glandular cells of the cervix.60% of LSIL and 80% of HSIL were positive for p16,MCM and cdc6 proteins in tissue samples. None of this markers exhibited acceptable sensitivity and specificity in cytology samples. The immature metaplastic cells show immunopositivity for all these markers. So there is a clinical need for alternative reliable low cost methods. Recently we have developed software for computerized screening of Pap smears which separates abnormal smears with a sensitivity of 80%. Attempts using Fourier psychographic microscopy are on progress to further improve the sensitivity and specificity of this software. While at the same time we found a differential spectrum on surface enhanced Ramen spectroscopy for the detection of Cervical Intra epithelial lesions. The whole proteome profile of cervical epithelial cells and its malignant and dysplastic counterpart revealed a series of differentially expressed proteins, some of which are being evaluated as candidate marker for Cervical Intra Epithelial Neoplasia.

Published: 11 May 2017