Usefulness of serum mass spectrometry to identify women diagnosed with higher grades of cervical intraepithelial neoplasia may differ by race

Abstract

Roland Matthews1, Andres Azuero2, Senait Asmellash3, Earl Brewster1, Edward E Partridge4, Chandrika J Piyathilake51Department of Obstetrics and Gynecology, The Morehouse School of Medicine, Atlanta, Georgia, USA; 2School of Nursing, 3Departments of Surgery, 4Obstetrics and Gynecology, 5Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USABackground: An early detection of precursor lesions of cervical cancer will help to eliminate the worldwide burden of cervical cancer.Methods: This exploratory study aimed to identify, by matrix-assisted laser desorption/ionization (MALDI) time-of-flight (TOF) mass spectrometry (MS), serum protein profiles that distinguish cervical intraepithelial neoplasia grades CIN 1 or lower (≤CIN 1) from CIN 2+ among 127 women infected with human papillomavirus (HPV) 16. Of these 127 women, 25 and 23 were diagnosed with CIN 2 or CIN 3, respectively (cases), and 79 were diagnosed with ≤CIN 1 (non-cases). Serum protein profiles were generated by MALDI-TOF-MS. A total of 95 m/z peaks were tested for association with case status by two racial groups, African American (AAs) and Caucasian American (CAs).Results: Overall, 2 protein peaks identified by our study demonstrated higher specificity for identifying CIN 2+ than previously published studies. An increasing intensity of [m/z 4459] was associated with a higher risk of being a case, regardless of race with a specificity of 58% for CIN 2 and a specificity of 75% for CIN 3. An increasing intensity of [m/z 4154] was not only associated with a higher risk of being a case only among CAs, but also had an opposite effect among AAs.Conclusion: Identification of specific proteins associated with the peaks detected in serum and development of antibody-based tests such as ELISA should lead to the development of race-specific, non-invasive and cost effective screening tests with higher specificity for identifying HPV 16 associated CIN 2+.Keywords: serum mass spectrometry, cervical intraepithelial neoplasia, race