Human Papillomavirus Testing in the Clinical Laboratory Part I: Squamous Lesions of the Cervix

Publisher Website
Google Scholar
Abstract
The aim of this study was twofold: (1) to evaluate the contribution of viral (HPV) testing for improving the sensitivity of cervical cytology and (2) to correlate HPV types with the histology of the detected cervical cancer precursors, particularly the low-grade, CINI variant. We used the dot blot hybridization technique (ViraPap) and polymerase chain reaction (PCR) in 63 women referred to our colposcopy clinic for evaluation of an abnormal Pap test. Histopathologic samples obtained by multiple colposcope-directed punch biopsies were used for a diagnostic gold standard. Among the 53 women with histologically proven CIN, precolposcopy cytology was positive in 38 (72%) compared to 53% and 60% HPV positivity by ViraPap and PCR, respectively (p < 0.01). When the yields of ViraPap/PCR and cytology were combined, however, the detection rate of CIN was 91%, a significant improvement over cytology alone (p < 0.02). HPV DNA was found either by ViraPap or PCR in 45 of 63 (71%) biopsy specimens, and 37 of 38 (97%) HPV-positive CIN, including the low-grade CIN I variant, contained oncogenic HPV types. HPV type 16 was present in 22 of 38 (58%) CIN lesions and mixed with HPV 6/11,18, or the 30s group in 6 of 38(16%) of the cases. HPV 6/11 alone was found only in 1 case of CINI(2.7%). HPV testing by molecular technology increases the sensitivity of cytology. However, large-scale studies on routine screens with emphasis on specificity and cost-effective analysis are needed to verify the findings of the present study. (J GYNECOL SURG 9:1, 1993)