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Cergy-Pontoise, France

Szarewski A.,University of London | Mesher D.,University of London | Cadman L.,University of London | Austin J.,University of London | And 12 more authors.
Journal of Clinical Microbiology | Year: 2012

High-risk human papillomavirus (HPV) DNA/RNA testing provides higher sensitivity but lower specificity than cytology for the identification of high-grade cervical intraepithelial neoplasia (CIN). Several new HPV tests are now available for this purpose, and a direct comparison of their properties is needed. Seven tests were evaluated with samples in liquid PreservCyt transport medium from 1,099 women referred for colposcopy: the Hybrid Capture 2 (Qiagen), Cobas (Roche), PreTect HPV-Proofer (NorChip), Aptima HPV (Gen-Probe), and Abbott RealTime assays, the BD HPV test, and CINtec p16INK4a cytology (mtm laboratories) immunocytochemistry. Sensitivity, specificity, and positive predictive value (PPV) were based on the worst histology found on either the biopsy or the treatment specimen after central review. Three hundred fifty-nine women (32.7%) had CIN grade 2+(CIN2+), with 224 (20.4%) having CIN3+. For detection of CIN2+, Hybrid Capture 2 had 96.3% sensitivity, 19.5% specificity, and 37.4% PPV. Cobas had 95.2% sensitivity, 24.0% specificity, and 37.6% PPV. The BD HPV test had 95.0% sensitivity, 24.2% specificity, and 37.8% PPV. Abbott RealTime had 93.3% sensitivity, 27.3% specificity, and 38.2% PPV. Aptima had 95.3% sensitivity, 28.8% specificity, and 39.3% PPV. PreTect HPV-Proofer had 74.1% sensitivity, 70.8% specificity, and 55.4% PPV. CINtec p16INK4a cytology had 85.7% sensitivity, 54.7% specificity, and 49.1% PPV. Cytology of a specimen taken at colposcopy (mild dyskaryosis or worse) had 88.9% sensitivity, 58.1% specificity, and 50.7% PPV. Our study confirms that, in a referral setting, HPV testing by a number of different tests provides high sensitivity for high-grade disease. Further work is needed to confirm these findings in a routine screening setting. Copyright © 2012, American Society for Microbiology. All Rights Reserved.

Cuzick J.,Queen Mary, University of London | Bergeron C.,Laboratoire Pasteur Cerba | von Knebel Doeberitz M.,University of Heidelberg | Jeronimo J.,PATH | And 5 more authors.
Vaccine | Year: 2012

The clearly higher sensitivity and reproducibility of human papillomavirus (HPV) DNA testing for highgrade cervical intraepithelial neoplasia (CIN) has led to widespread calls to introduce it as the primary screening test. The main concern has been its lower specificity, due to the fact that it cannot separate transient from persistent infections, and only the latter are associated with an increased risk of high-grade CIN and cancer. Thus, even proponents of HPV testing generally only recommend it for women over the age of 30 years (or in some cases 35 years). If HPV testing is to reach its full potential, new approaches with better specificity are needed, either as triage tests for HPV positive women or, if the high sensitivity of HPV DNA testing can be maintained, as alternate primary screening modalities. Approaches that may useful in this regard, especially as triage tests, include HPV typing, methylation (and consequent silencing) of host and viral genes, and new cytologic methods, such as p16INK4a staining, which attempt to identify proliferating cells. At an earlier stage of development are direct methods based on detection of HPV E6 or E7 proteins. Recent progress and current status of these methods is discussed in this chapter. The current status of visual inspection (VIA and VILI) methods is also surveyed and progress on self-sampling is reviewed. © 2012 Published by Elsevier Ltd.

Lesesve J.-F.,Nancy University Hospital Center | Gressot A.-L.,Nancy University Hospital Center | Troussard X.,Caen University Hospital Center | Mossafa H.,Laboratoire Pasteur Cerba | Cornet E.,Caen University Hospital Center
Leukemia and Lymphoma | Year: 2014

The observation of binucleated lymphocytes (BNLs) on a peripheral blood smear is essential to the diagnosis of persistent polyclonal B-cell lymphocytosis (PPBL). Only a few case reports have mentioned their presence in other contexts, mainly mature B-cell neoplasms such as chronic lymphocytic leukemia or reactive circumstances such as multiple sclerosis undergoing natalizumab treatment. We sought to investigate whether any particular morphologic features of BNL were more specific to PPBL than other diseases. We reviewed peripheral blood smears of a series of patients affected by PPBL or harboring BNLs whatever the diagnosis. We found that BNLs in PPBL were heterogeneous, but mostly medium-sized with a moderately abundant basophilic cytoplasm, sometimes vacuolated. The chromatin was mature in an asymmetrically bilobed nucleus showing one to two nucleoli. Though mainly observed in patients with PPBL, all these criteria remained non-specific. Conversely, the presence of either monocytoid or hyperbasophilic cells had clinical value to confirm PPBL. We conclude that a substantial percentage of BNLs possessing the morphologic features described and observed in a context of monocytoid and/or hyperbasophilic lymphocytes is predictive of the diagnosis of PPBL. © 2014 Informa UK, Ltd.

Carod J.-F.,Institute Pasteur Of Madagascar | Randrianarison M.,Center Hospitalier Soavinandriana | Razafimahefa J.,Service de Neurologie | Ramahefarisoa R.M.,Institute Pasteur Of Madagascar | And 6 more authors.
Diagnostic Microbiology and Infectious Disease | Year: 2012

This study aimed to evaluate 5 enzyme immunoassays for detecting human antibodies against Taenia solium in human serum and for the diagnosis of neurocysticercosis (NCC): DRG RIDASCREEN, NOVATECH, CYPRESS, and IVD A collection of 114 reference serum samples were used. All sera were tested both by ELISA and by an immunoblot method (enzyme-linked immunoelectrotransfer blot [EITB]). When compared with EITB, the Ridascreentest had the best positive concordance rate (85.1-91.2%) and the NovaLisa test showed the optimal negative concordance rate (93.7-95.6%). All tests had a sensitivity under 72% and a specificity above 60%. The best sensitivity was obtained using Ridascreen test (71.4%). An optimal specificity was achieved by the NovaLisa test. T. solium-positive sera all cross-reacted with E. granulosus positive samples. In the commercial assays evaluated here, the most appropriate ELISA test for screening may be the Ridascreen assay. Antibody detection seems to be not appropriate for NCC diagnosis because of its overall lack of sensitivity. © 2012 Elsevier Inc.

Cavalier E.,University of Liege | Rozet E.,University of Liege | Gadisseur R.,University of Liege | Carlisi A.,University of Liege | And 5 more authors.
Osteoporosis International | Year: 2010

Due to "measurement uncertainty", the "true" 25-OH vitamin D (25(OH)D) of a patient (whatever the commercially available assay tested) will be >80 nmol/L if its measured concentration is >100 nmol/L. Thus, if a physician considers that a normal VTD status is a 25(OH)D level ≥80 nmol/L, he should ensure that the patient's results are ≥100 nmol/L. Introduction: Many experts recommend that serum levels of 25(OH)D should be above a lower normal limit of 75-C 80 nmol/L. However, the value delivered by laboratories is only an estimation of the "true" value due to "measurement uncertainty." When using a cut off, measurement uncertainty around the cut off is important because therapeutic actions may differ if the measured value is below or above the limit. We aimed to establish the "measurement uncertainty" at different levels of concentration for several commercially available 25(OH)D analytical techniques. Methods: We constituted three pools of serum with different 25(OH)D concentrations. Each pool was assayed in triplicate during 5 days with the DiaSorin RIA, Liaison, Elecsys, and Chromsystems-HPLC assays. Results: We report a relatively high "measurement uncertainty" for the measurement of 25(OH)D for the four different techniques: the mean relative uncertainties, all techniques confounded were 19.4%, 16.0%, and 11.3% for pool 1 (35.3 nmol/L), pool 2 (79.5 nmol/L), and pool 3 (126.1 nmol/L), respectively. Conclusions: Our results show that, whatever the assay, the "true" 25(OH)D of a patient will be >80 nmol/L if its measured concentration is >100 nmol/L. In other words, if a physician considers that a normal VTD status is defined by a 25(OH)D level ≥80 nmol/L, he should ensure that the patients present a 25(OH)D ≥100 nmol/L. © International Osteoporosis Foundation and National Osteoporosis Foundation 2009.

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