Human papillomavirus testing improves the accuracy of colposcopy in detection of cervical intraepithelial neoplasia
| Autor: | C. Semaille, M. Beumont, Eduardo L. Franco, Javier Pintos, R. Dachez, Alois Bianchi, L. Zerat, Joseph Monsonego |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent medicine.medical_treatment Uterine Cervical Neoplasms Cervical intraepithelial neoplasia Sensitivity and Specificity Colposcopic Biopsy Abnormal PAP Smear medicine Humans Papillomaviridae Aged Vaginal Smears Colposcopy Gynecology medicine.diagnostic_test business.industry Papillomavirus Infections Reproducibility of Results Obstetrics and Gynecology Gold standard (test) Middle Aged Uterine Cervical Dysplasia medicine.disease female genital diseases and pregnancy complications Oncology Loop electrical excision procedure DNA Viral Female business Ascus Viral load Papanicolaou Test |
| Zdroj: | International Journal of Gynecological Cancer. 16:591-598 |
| ISSN: | 1525-1438 1048-891X |
| Popis: | To assess the performance of human papillomavirus (HPV) testing and colposcopy in detection of cervical pathology. A series of 389 women referred for colposcopy due to an abnormal Pap smear had cervical swabs analyzed for oncogenic (high-risk [HR]) HPV types using Hybrid Capture II (HC2) assay. Loop electrical excision procedure cone biopsy (88%) or colposcopic biopsy (11%) was used as the gold standard. Of the atypical squamous cells of undetermined significance (ASCUS) smears, 48% were positive for HR HPV, as compared to 76.3% of low-grade squamous intraepithelial lesions (LSIL) smears. HR HPV was detected in 66.7% and 90% of patients with cervical intraepithelial neoplasia (CIN) 1 and CIN2 (or higher), respectively. The sensitivity of the Pap smear using an ASCUS threshold in detecting high-grade CIN was 94.5% (95% confidence intervals (CI): 91–97%) and that of colposcopy 98.5% (95% CI: 95–99%). The respective specificities were 30% (95% CI: 17–28%) and 35.6% (CI: 29–42%). HC2 test had comparable sensitivity, 90% (95% CI: 85–93%), but higher specificity, 54.3% (95% CI: 47–61%). Combining HC2 test with Pap increased specificity, 66.7% and 41.3% for ASCUS and LSIL cutoff, respectively. The minor-abnormality threshold together with HC2 increased specificity of colposcopy with no changes in sensitivity. High viral load (>100 relative light unit/positive control) was associated with significant disease. HPV DNA testing improves the accuracy of colposcopy in the detection of high-grade CIN in women with ASCUS or LSIL smears. |
| Databáze: | OpenAIRE |
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