[The correlation of a positive DNA HPV HR test and genotyping human papilloma viruses with the presence of CIN, in women with cytologic evidence of ASC-US and LSIL].
ABSTRACT Diagnostic algorithm for women with ASC-US presumes the possibility of performing molecular test for DNA HPV HR, colposcopy or repeated cytology. The latest suggestions of diagnostic algorithm modification in case of cytologic interpretation of LSIL, are based on trial of performing molecular DNA HPV HR test and/or genotyping human papilloma viruses with the special indication for type 16. These suggestions presume performing colposcopy in women with DNA HPV HR or DNA HPV 16 (+).
Triage study included 67 women with ASC-US and 48 women with LSIL. All 115 women were examined with the use of molecular test Amplicor HPV Roche Diagnostics, which identifies the presence of any out of 13 oncogenic DNA HPV types. 14 women with LSIL DNA HPV HR (+) interpretation, were additionally tested for identification of HPV genotypes presence. In all women with cytologic evidence of ASC-US and LSIL, a colposcopic examination was further performed.
Among 67 examined women with ASC-US interpretation, 31 had a (+) test for the presence of any out of 13 HPV HR, while in 12 patients, the result of pathomorphological examination confirmed at least the presence of CIN 1. In none of 36 patients with ASC-US, DNA HPV HR (-) interpretation, the presence of CIN was confirmed. For 29 women with LSIL, (+) test result for any out of 13 HPV HR was obtained. In 117 patients OUT of this group, at least the presence of CIN 1 was recognized. Following 19 women with LSIL had a negative test result for DNA HPV HR. In none of the patients with DNA HPV HR (-), the presence of CIN was confirmed. DNA HPV 16 was recognized in 5/9 patients with LSIL, without CIN. In 5 patients with LSIL, who underwent HPV genotyping, and were diagnosed for CIN, 4/5 were DNA HPV 76 (+). The most common HPV types in women with LSIL and the presence of CIN include; HPV 16 and HPV 37.
1. Negative DNA HPV HR result, identifies precisely women with ASC-US and LSIL, without CIN. 2. Genotyping exclusively DNA HPV 16 in women with LSIL, in order to detect CIN is characterized by lower sensitivity and specificity in comparison with universal test for 13 oncogenic HPV types.