MSACL 2019 EU Abstract

The Use of Rapid Evaporative Ionisation Mass Spectrometry (REIMS) as a Real-Time Bedside Test in Cervical Cancer Screening

Maria Paraskevaidi1, Simon Cameron2, Eilbhe Whelan1,3, Menelaos Tzafetas1,3, Anita Mitra1,3, Sarah Lever1,3, Anita Semertzidou1,3, Zoltan Takats1,2, Maria Kyrgiou1,3
1Department of Surgery and Cancer, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, W12 0NN, UK 2Department of Computational and Systems Medicine, Faculty of Medicine, Imperial College London, London, SW7 2BX, UK 3West London Gynaecological Cancer Center, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, W12 0HS, UK

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Maria Paraskevaidi (Presenter) Imperial College London

Relevant Financial Disclosures (within past 24 months) No relevant financial relationship(s) to disclose. Discussing Products? NO, presenter will NOT present educational content related to products/services of the ineligible company(ies) listed above. Conflict mitigation NOT REQUIRED.

Background / Objectives: Cervical cancer is the 4th most common cancer among women while its incidence is expected to rise by 43% in the UK by 2035 (Cancer Research UK, 2019). The microscopic examination of cervical cells currently carried out to screen asymptomatic women is prone to human error and can lead to high numbers of false-positives and false-negatives. Primary HPV DNA testing has been shown to be more accurate in screening and therefore is projected to replace cytology in the UK by the end of 2019 (Rebolj et al., 2019). Rapid evaporative ionization mass spectrometry (REIMS) is an innovative technique that allows interrogation of biological samples without any need for laborious sample preparation. Our main objective is to establish whether REIMS can be employed for the detection and grading of pre-invasive cervical changes. We also seek to assess the ability of REIMS to distinguish women with high-risk HPV (hrHPV) infection from women without infection.

Materials and Methods: Cell pellet from liquid-based cytology (LBC) samples has been analysed with REIMS. During REIMS, laser energy is directed to the sample of interest and rapid heating results in a vapour containing gas phase ions. The generated ions are introduced into a spectrometer and a mass spectrum with molecular information is produced. Samples from more than 400 women, with recorded hrHPV genotype and cytological / histological results, have been used. The derived mass spectra are used to differentiate between women with precancerous changes as well as those being hrHPV positive and negative.

Results: Our preliminary results show that REIMS can predict the presence and grade of disease with higher accuracy than current cytology. The diagnostic accuracy of REIMS was also comparable to the gold-standard HPV genotyping.

Conclusions: Using a near-real-time, bedside technique such as REIMS would reduce cost, repeated visits and prolonged waiting times, benefitting both clinicians and patients.

References
Cancer Research UK.
Rebolj M, Rimmer J, Denton K, Tidy J, Mathews C, Ellis K, et al. Primary cervical screening with high risk human papillomavirus testing: observational study. BMJ 2019; 364: l240.