#IWD2018 - DIT research aims to establish new test for cervical pre-cancerPosted: 8 March, 2018
Researchers at the DIT Radiation and Environmental Science Centre (RESC), under the leadership of Professor Fiona Lyng, may be on the cusp of a major breakthrough in cervical pre-cancer diagnosis.
The team at RESC has been developing a novel technology for cervical cancer screening based on Raman spectroscopy for a number of years. Now, they are carrying out a clinical utility study of 1,000 patient samples to establish the accuracy of the new testing method.
“To our knowledge, this is the largest patient study using this type of spectroscopic assay in the world,” explains Fiona. “Previously, people have only looked at up to 100 patient samples. Raman spectroscopy is a powerful tool that uses light to generate a biochemical fingerprint of cells. We are currently building a large database from the 1,000 samples, so that we can map out the biochemical fingerprint of cells at different stages of cervical pre-cancer.”
Fiona was appointed as the Centre Manager of RESC in 2003. Her relationship with DIT stretches back to her undergraduate years when she studied Physics in DIT Kevin Street. There, she was mentored by Dr Carmel Mothersill, a trailblazer in the area of radiation biology, who inspired her to apply her physics knowledge to make an impact in human health. A prolific researcher, having published over 100 research papers and supervised 26 PhD students to completion, Fiona was awarded a Professorship by DIT in 2012 and the ‘One to Watch’ Award in 2011 by Enterprise Ireland, who previously funded the project for five years.
A lot is changing in cervical cancer screening because of HPV, a sexually transmitted infection which can be genital or oral. For women, persistent HPV infections can cause abnormal changes in the lining of the cervix, which can lead to cervical cancer (Irish Cancer Society). HPV is implicated in 98% of cervical cancers, explains Fiona, and as a result HPV testing has recently been been introduced by CervicalCheck, Ireland’s cervical screening programme.
Current cervical cancer screening is by the Pap test or cervical smear test. Cells are taken from the cervix and sent to a cytology lab, where the cytologist uses a microscope to analyse the structure of the cells: size and shape, staining patterns. “The main problem with the Pap test is that it is subjective and therefore, subject to human error. Missed or incorrect diagnoses are common. The Pap test has saved many lives, but it’s been around since the 1940s, it’s time for a new test.”
If low grade changes are found in the cells by cytology, the sample is also tested for the presence of HPV. If you test positive for HPV, you will be sent for a number of further tests, for example colposcopy and biopsy. “A lot of women are sent for colposcopy when they might not necessarily need it. The HPV infection is very common and usually clears up by itself. It only causes pre-cancer in a percentage of women. A colposcopy exam can be an unnecessary procedure and can cause a lot of extra worry for the woman.”
The potential impact of the new testing method is huge.
Fiona says that their test can tell from the cellular biochemical fingerprint if the sample is positive for HPV and further, whether the cells are at risk to go on to pre-cancer or whether the infection is transient and will resolve itself. This new technique uses classification algorithms to analyse Raman spectra of cells, comparing them with the predefined database of samples. The system is completely objective and does not rely on human subjectivity.
“The dream would be to see it used as the main test for cervical pre-cancer in Irish hospitals and cytology labs. This new test could help achieve an earlier and more accurate diagnosis for women, reducing stress on the patient and ultimately saving lives.” It is also more cost effective, as all of this is possible by analysing the biochemical fingerprint of the sample you originally give to your GP.
With more than 800 samples analysed out of 1000, the results so far are good. “We’ve gotten greater than 90% specificity and sensitivity in our results so far. It’s very exciting.”
The clinical utility study is due to be completed in 2018. If the results continue to shine, the team is hoping to generate interest from companies that could bring the test to market. They are also working to translate over to other cancers, for example oral cancer and lung cancer.
Damien Traynor is a fulltime Research Assistant on the team. Dr Shiyamala Duraipandian, a postdoctoral Marie Sklodowska-Curie Research Fellow who worked on the project for the past two years, recently moved on to a full-time position with the Danish National Metrology Institute (DFM).
The clinical utility study is being carried out as part of the CERVIVA Consortium, a collaborative research group focused on cervical cancer screening and other Human Papillomavirus (HPV) associated diseases, which is led by The Coombe Women and Infants University Hospital (Professor John O’Leary and Dr Cara Martin), in partnership with DIT, Trinity College Dublin and The National Cancer Registry.
Along with using Raman and infrared spectroscopy for cancer diagnosis, RESC specialises in radiation biology and environmental toxicology. RESC is located in the FOCAS Institute, a research facility at DIT dedicated to surface engineering, nanotechnology, photonics and biophotonics, materials science and radiation biology.
This article was originally published in the DIT Research News Magazine. If you would like to read more articles from the magazine, click here.