Abstract
BackgroundWe evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women.MethodsAll women with liquid-based cytology performed at a University Hospital between 2000 and 2003 were included. The Hybrid Capture 2 (HC2) kit and in house Polymerase Chain Reaction (PCR) were used for HPV DNA detection. Cervical biopsy was performed for women with ASCUS+ cytology, HPV detection, or abnormal colposcopy. Positive (PLR) and negative (NLR) likelihood ratios were calculated for cytology and HPV molecular testing for the prediction of CIN2 and greater histology.ResultsOf the 1270 women evaluated 241 (18.5%) had abnormal cytology. Cytology diagnosed high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma in 21(1.7%) cases whereas 26 (2%) women had CIN2+ or greater histology. PCR detected HPV in 397/1270 (31.3%) and HC2 in 260/1270 (20.4%) samples. Both molecular tests exhibited high reproducibility (Cohen's kappa value 0.691, 95% CI: 0.664 - 0.718). Positive likelihood ratios (PLR) of 9.4, 3.8 and 3.4 and negative likelihood ratios of 0.13, 0.21, and 0 were noted for ≥ LSIL, any positive HC2 or any positive PCR-HPV testing, for predicting CIN2+ histology, respectively. All CIN 3+ lesions harbored high risk oncogenic HPV type infections.ConclusionsHPV infection was found in a large proportion of this population and was associated with CIN 2/3 lesions and infiltrating carcinomas. Thin prep testing and HPV detection by HC2 or PCR performed very well with regards to identifying high grade lesions in an environment with experienced examiners.
Highlights
We evaluated two molecular methods of human papilloma virus (HPV) detection and their correlation with cytological and histological diagnosis in a large sample of Greek women
HPV infection was found in a large proportion of this population and was associated with cervical intraepithelial neoplasia (CIN) 2/3 lesions and infiltrating carcinomas
Newer molecular techniques have greatly helped in identifying the association of high-risk HPV types with the development of precancerous lesions, as well as their role in cervical carcinogenesis[3,4]
Summary
We evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women. Large epidemiological studies performed over the last two decades have identified infection with human papilloma virus (HPV) as a necessary cause for cervical cancer[1,2]. Newer molecular techniques have greatly helped in identifying the association of high-risk HPV types with the development of precancerous lesions, as well as their role in cervical carcinogenesis[3,4]. Since the vast majority of invasive cervical carcinoma cases are associated with HPV type 16 or 18 infections[5,6], efforts have been made to develop preventive measures for infections with these high risk. HPV types: two specific vaccines targeting infection with HPV types 16 and 18 have recently been introduced[7].
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