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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Gynecological Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1423128
This article is part of the Research Topic Tailoring Treatment in Invasive and Non-Invasive Cervical Pathology Volume II View all 4 articles

Clinical Value of Optical Coherence Tomography in the Early Diagnosis of Cervical Cancer and Precancerous Lesions: A Cross-sectional Study

Provisionally accepted
Xiaoli Cui Xiaoli Cui 1*Di Yang Di Yang 1Jing Zhang Jing Zhang 1Yuqian Zhao Yuqian Zhao 2Zhumei Cui Zhumei Cui 3Chunyan Wang Chunyan Wang 1*You-lin Qiao You-lin Qiao 4
  • 1 Liaoning Cancer Hospital, China Medical University, Shenyang, China
  • 2 Sichuan Cancer Hospital, Chengdu, Sichuan Province, China
  • 3 The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
  • 4 Chinese Academy of Medical Sciences and Peking Union Medical College, Dongcheng, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Background: This study aimed to measure the accuracy of optical coherence tomography (OCT) in the early diagnosis of high-grade cervical lesions and assess its diagnostic value in the triage of high-risk HPV infection.Method: From Jan 2019 to Jan 2021, women who visited the gynecology clinics of 2 hospitals for colposcopy were invited to participate in this study.Women aged 35 to 64 years old who were sexually active and had an intact cervix with a diameter of more than or equal to 2 cm were included in this study. Additionally, individuals with abnormal cytology, positive HPV test results, or other clinically suspicious symptoms or signs were referred. All participants were examined before colposcopy using OCT. Biopsy and/or ECC were conducted under colposcopy. We used the results of histopathology as the gold standard and assessed the accuracy of OCT.Results: Overall, 883 women were included in the analysis. Approximately 13.25% of women were ASCUS+ in cytological assessments, and 22.31% were positive for high-risk HPV. Nearly 15.18% of women were positive in OCT. Of them, 27 women were diagnosed with CIN2, and 33 were diagnosed with CIN3+ lesions. Among HPV-positive women, the detection rates for CIN2+ and CIN3+ were much lower for those who were negative in OCT, compared with NILM cytology (CIN2+: 20.0% vs. 30.0%, P=0.002, and CIN3+: 18.2% vs.27.3%, P=0.013). Among women who were positive for HPV16/18, the detection rate for CIN2+ was much lower for negative OCT, compared with NILM cytology (8.3% vs.15.0%, P=0.005). Compared to HPV and cytological tests, HPV combined with OCT had higher specificity for detecting CIN2+ and CIN3+ (96.1% vs. 93.2%, P=0.002; 93.8% vs. 91.3%, P=0.013). OCT triage after HPV genotyping had the highest AUC for detecting CIN2+ and CIN3+ cases among patients with high-risk HPV infection (0.921, 0.920).OCT is an accurate test for the early diagnosis of high-grade cervical lesions and has great diagnostic value in the triage of patients with high-risk HPV infection.

    Keywords: cervical cancer, Precancerous lesions, OCT, early diagnosis, screening

    Received: 28 Apr 2024; Accepted: 12 Jul 2024.

    Copyright: © 2024 Cui, Yang, Zhang, Zhao, Cui, Wang and Qiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xiaoli Cui, Liaoning Cancer Hospital, China Medical University, Shenyang, China
    Chunyan Wang, Liaoning Cancer Hospital, China Medical University, Shenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.