# Raman Spectroscopy of Cell-Free Cervicovaginal Lavage for HPV Lesion Diagnosis: A Pilot Study

## TL;DR

This pilot study explores using Raman spectroscopy on cell-free cervicovaginal fluid to distinguish between low- and high-grade cervical lesions caused by HPV, offering a non-invasive diagnostic tool.

## Contribution

The study pioneers the use of Raman spectroscopy on cell-free cervicovaginal lavage to differentiate between LSIL and HSIL in HPV-positive patients.

## Key findings

- Raman spectroscopy detected biochemical changes in cell-free CVL samples, including reduced glycogen and lactate and increased heme proteins in high-grade lesions.
- A diagnostic model achieved 80% sensitivity and 86% specificity in differentiating LSIL and HSIL.
- The method shows potential as a non-invasive, rapid, and cost-effective tool for cervical lesion risk stratification.

## Abstract

High-risk human papillomavirus (HPV) is the leading etiological factor in cervical cancer, creating a pressing need for less invasive and more objective diagnostic tools. This pilot study pioneers the application of Raman spectroscopy to cell-free cervicovaginal lavage (CVL) for distinguishing between low-grade and high-grade squamous intraepithelial lesions (LSIL and HSIL) in HPV-positive patients. Raman spectra were acquired at 532-nm excitation from cell-free CVL samples of 20 patients with histologically confirmed LSIL (n = 9) or HSIL (n = 11). Comparative analysis of Raman bands revealed a significant biochemical shift in HSIL, presumably characterized by reduced glycogen and lactate/lactic acid levels alongside substantially elevated heme proteins. A diagnostic model based on key spectral intensity ratios achieved differentiation between LSIL and HSIL with 80% sensitivity and 86% specificity. These findings demonstrate that Raman spectroscopy of cell-free CVL effectively captures profound metabolic and microvascular alterations characteristic of neoplastic progression, showcasing its strong potential as a rapid, cost-effective, non-invasive, and objective tool for cervical lesion risk stratification.