Search for Markers in HPV-Associated Cervical Lesions Using the Chromatography-Mass Spectrometry
Study Objective: To study the Lipid composition of cervical epithelium in HPV-associated lesions in order to search for markers for early non-invasive diagnosis of squamous intraepithelial lesions (SIL) of the cervix. Study Design: cross-sectional prospective cohort study. Materials and Methods. The study included 124 patients aged 21 to 45 years old. For scraping of the epithelium in the cervix and cervical canal, a cervical brush was used. The lipidic extract from a scraping sample was analysed with the use of chromatography-mass spectrometry (positive and negative ions). Possible markers were searched for with the help of the Mann-Whitney test and analysis of views for hidden structures; logistic regression variables were selected based on the Akaike information criterion. The models were tested with cross validation of a separate item. Study Results. We have identified lipids belonging to cholesterol esters, phosphatidylcholines, ceramides and sphingomyelins, which allow differentiating between normal conditions, cervicitis, high- and low-grade SIL, and cervical cancer. The model accuracy for positive and negative ion modes was 70% and 71%, respectively. The final model accuracy was 79% and demonstrated high predicative value for cervicitis and cervical cancer and moderate predicative value for low-grade SIL vs. norm. Conclusion. The potential for non-invasive cervical SIL differentiation using lipid markers has been demonstrated.