Diagnostic techniques for human papillomavirus detection for early diagnosis of endocervical adenocarcinoma

Abstract

Background: The past few decades have witnessed a shift in the rate of incidence of cervical squamous cell carcinoma (SCC) and endocervical adenocarcinoma because there has been an increase in the prevalence of the endocervical adenocarcinoma and a reduction in the SCC in countries with effective screening programs in place. Although our knowledge about the underlying reasons for this shift remains deficient, it seems that the prevalence of endocervical adenocarcinoma is on the rise partly because of greater exposure to human papillomavirus (HPV), screening delays, and more importantly, technical limitations faced in diagnosing endocervical carcinoma. Objectives: This study aims to systematically review certain diagnostic methods that detect HPV which will facilitate the early diagnosis of endocervical adenocarcinoma because adjuvant therapy has proven to be inefficient for later stages of the disease. Methodology: The relevant articles were researched online using databases such as Scopus, PubMed, ScienceDirect, ProQuest, SpringerLink, and Web of Science. The databases were electronically searched. The keywords used in the search included “human papillomavirus (HPV),” “diagnosis of endocervical adenocarcinoma,” “polymerase chain reaction (PCR),” “in situ hybridization (ISH),” and “immunohistochemistry (IHC).” The search was refined to include only those articles that were nonreviewed studies and recently published, covering the period from 2010 to the present. Results: Eight articles from different parts of the world were selected for the study and were categorized into three groups depending on the diagnostic technique used in them, which included PCR, ISH, and IHC. PCR has proven to be an efficient noninvasive method that detects HPV DNA in the early stages. ISH demonstrates high specificity and sensitivity for the detection, of which genotypes of HPVs are present in endocervical adenocarcinoma lesions. Immunohistochemical staining is a simple tool for detecting HPV, but it has limited efficiency. Conclusion: A number of diagnostic tools are available to detect HPV infection for the early diagnosis of endocervical adenocarcinoma. HPV detection tests can be used in combination with the Pap test to ensure that any abnormality is not missed during diagnosis. Nonetheless, further studies should be performed to develop novel techniques or improve existing ones, so that endocervical adenocarcinomas can be detected on time and with high accuracy, and to overcome the problems faced in the cytologic diagnosis of cervical adenocarcinomas lesions.