Detection of Human Papillomavirus in Male and Female Urine by Electrochemical DNA Chip and PCR Sequencing

Abstract

Background: Cervical cancer is the second most common cancer in Thai women after breast cancer. Currently, the Papanicolaou (Pap) smear is the recommended procedure for cervical cancer screening in Thailand, but only a relatively small percentage of women follow this screening program. An alternative method to detect HPV genotypes associated with cervical cancer is self-sampling of urine, which is a more widely accepted method. Our study aimed to evaluate the prevalence of HPV in Thai women using urine and cervical swabs and prevalence of HPV in Thai men using urine samples. Materials and Methods: Tumorigenic HPV detection was accomplished by electrochemical DNA chip and PCR/direct sequencing. In addition to HPV prevalence, we report the concordance between different methods and sample types. One-hundred and sixteen women and 100 men were recruited. Histological examination revealed normal cytology in 52 women, atypical squamous cells of undetermined significance (ASCUS) in 9, low-grade squamous intraepithelial lesions (LSIL) in 24, and high-grade squamous intraepithelial lesions (HSIL) in 31. One-hundred men were classified as heterosexuals (n=45) and homosexuals (n=55). Results: The most prevalent HPV genotype in our study was HPV16. The HPV detection rate was generally lower in urine samples compared with cervical samples. Overall, there was good agreement for the detection of carcinogenic HPV from female cervical samples between the DNA chip and PCR/ sequencing, with 88.8% total agreement and a kappa value of 0.76. In male urine samples, the level of agreement was higher in heterosexuals compared with homosexuals. Conclusions: Further improvement is required to increase an overall yield of HPV DNA detection in urine samples before clinical application of a urine-based HPV screening program. The electrochemical DNA chip test is a promising technique for carcinogenic HPV detection.

Comparison of human papillomavirus (HPV) detection in urine and cervical swab samples using the HPV GenoArray Diagnostic assay

“…When cervical testing for HPV is required, these results suggest that urine sample collection provides an alternative non-invasive sampling method for monitoring HPV infection in women. In a previous study, the overall percentage agreement between HPV detection in urine and cervical samples was 88% using the Cobas 4800 HPV test (Bernal et al, 2014), 75% using an electrochemical DNA chip (Nilyanimit et al, 2013) and, in this study, the percentage was 65.2%. The undeniable advantage in testing urine sample is its acceptance and convenience for the patients, although better results are obtained with first urine in the morning (Vorsters et al, 2014).…”

“…HPV DNA urine testing can be used to identify abnormal cells in adolescent girls and young women who do not wish to have a vaginal examination (Vorsters et al, 2014; Enerly, Olofsson & Nygård, 2013). Some studies have reported a high HPV detection sensitivity for urine-based assays (Forslund et al, 1993; Hagihara et al, 2016; Bernal et al, 2014), while other studies have reported a low HPV detection sensitivity from urine-based assays (D’Hauwers et al, 2007; Nilyanimit et al, 2013). …”

The Utility of Urine-Based Sampling for Cervical Cancer Screening in Low-Resource Settings

“…The overall concordance percentage reported in the present study was in accordance with the study carried out in Thailand (Nilyanimit et al, 2017). There are reports of good agreement of HPV DNA detection in paired urine and cervical samples (Tanzi et al, 2013;Sahasrabuddhe et al, 2014;Stanczuk et al, 2003;Nicolau et al, 2014;Nilyanimit et al, 2013;Bernal et al, 2014). Another study carried out among thirty cervical cancer cases, urine samples of 28 cases were HPV DNA positive, while all the thirty cervical samples were tested predictive value of HPV detection in urine samples was 96.4% and negative predictive value 39%.…”

Comparison of Detection Sensitivity for Human Papillomavirus between Self-collected Vaginal Swabs and Physician-collected Cervical Swabs by Electrochemical DNA Chip

“…Moreover, the cost of testing may discourage patients from choosing to screen for HPV (Oranratanaphan et al, 2014). To improve screening coverage, self-administered sample collection could be an alternative to Pap smear test (Nilyanimit et al, 2013;Scarinci et al, 2013). Previous studies examined the sensitivity and predictive value of HPV detection by comparing self-collected and physician-collected samples for HPV screening.…”