Innovative molecular markers for diagnosis and prognosis in cervical neoplasiaBoers, A. 2014 [S.l.]: [S.n.]. 212 p.
Research output: Thesis › Thesis fully internal (DIV)
Cervical cancer is the third most frequent carcinoma in women worldwide caused by high-risk human papillomavirus (hrHPV) infection. The most widely used cervical cancer screening test is cytomorphological examination of cervical scrapings. Howev¬er, methodology for primary screening is currently changing and hrHPV testing is becoming the preferred test. By hrHPV testing the sensitivity for detecting (pre)malignant cervical lesions is higher compared to cytomorphology. However, a disadvantage is its lower specificity, because also scrapings of women with transient HPV infections that will not devel¬op into (pre)malignant lesions are hrHPV positive. To prevent unnecessary referrals to gynecologists, risk stratification by triage testing of hrHPV positive women is needed. DNA methylation comprises epigenetic alterations during the development of cervical carcinogenesis and represents an excellent target for novel diagnostic approaches based on methylation specific PCR assays. In this thesis, we identified novel methylated markers that are specific for premalignant cervical lesions. We describe a set of methylation markers that were positive in most scrapings from women with (pre)malignant lesions, while normal scrapings were almost all negative. We showed that the use of these methylation assays is also feasible on brush-based self-sampling devices that might become a common collection approach in our new population-based screening program and is not suitable for cytomorphological examination. Apart from optimizing screening strategies for cervical cancer, there is also room for improvement of different aspects of current standard of care of cervical cancer patients. In conclusion, in this thesis improvements for screening and treatment of cervical cancer patients are shown.
|Qualification||Doctor of Philosophy|
|Place of Publication||[S.l.]|
|State||Published - 2014|
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