It must be emphasized that comparison of results obtained from the three different TEG assays should be avoided due to the significant differences between the assays documented in the present study.
One of the key differences between the assays is that the actin assay is done at 37°C on a heated microscope stage whereas the antibody staining assay was done in a 37°C incubator.
Our results show clear performance differences between the assays (Table 3A), with HPV DNA testing having the best sensitivity and specificity when defining cases as CIN2+ or CIN3+ (84.2% and 81.3% for CIN2+; 100% and 80.72% for CIN3+).
There were significant differences between the assays, and in the effect of food concentration between the assays (ASSAY: F9,542 = 6.43, p < 0.001; FOOD*ASSAY: F9,542 = 3.28, p < 0.001).
There were also significant differences between the assays, and in how the populations grew between assays (ASSAY: F7,1039 = 130.84, p < 0.001; TIME*ASSAY: F14,1039 = 102.49, p < 0.001).
As new assays become available, it will be critically important to understand the differences between the assays to comprehend the implications for clinical practice.
To answer the second question and to reveal differences between the assays, we further determined how often serum is negative in one test but positive in another test (Table 2).
This discrepancy may be due to differences in gene expression between tissue and cells [ 74], differences in IL-6 expression with tumor grade/invasiveness [ 65], degree of "stemness" in cell lines vs. tissue [ 75], and differences between the assays and/or sample collection.
