Performance of p16INK4a-cytology, HPV mRNA, and HPV DNA testing to identify high grade cervical dysplasia in women with abnormal screening results

2010 ◽  
Vol 119 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Miriam Reuschenbach ◽  
Andreas Clad ◽  
Christina von Knebel Doeberitz ◽  
Nicolas Wentzensen ◽  
Janina Rahmsdorf ◽  
...  
Keyword(s):  
Cervical Dysplasia ◽  
High Grade ◽  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Hpv Mrna

Human papillomavirus (HPV) DNA and mRNA primary cervical cancer screening: Evaluation and triaging options for HPV-positive women

2019 ◽  
Vol 26 (4) ◽  
pp. 212-218
Author(s):  
Suleeporn Sangrajrang ◽  
Piyawat Laowahutanont ◽  
Metee Wongsena ◽  
Richard Muwonge ◽  
Weerawut Imsamran ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Genotyping ◽  
Hpv Dna Testing ◽  
Hpv Types ◽  
Liquid Based Cytology ◽  
Hpv Mrna ◽  
Oncogenic Hpv

Objective Cervical cancer is the second most common cancer in Thai women; human papillomavirus (HPV) is the main cause. This study aimed to determine the clinical performance of HPV mRNA compared with HPV DNA testing. Methods Cervical specimens were collected from women aged 35 to 60 who attended the routine organized screening programme. We compared accuracy parameters of standalone HPV mRNA and HPV DNA tests, and those of triaging with liquid-based cytology or HPV genotyping and liquid-based cytology for those positive only for the less oncogenic HPV types. Test accuracy parameters were estimated using latent class analysis using Bayesian models. Results Of the 5046 women enrolled, 174 (3.4%) were HPV DNA positive and 141 (2.8%) HPV mRNA positive. Colposcopy compliance was 95.4% ( n = 166) among HPV DNA-positive women and 94.3% ( n = 133) among those HPV mRNA positive. The estimated sensitivity, specificity, and positive predictive value for detection of CIN2 or worse were 67.4%, 97.1%, 12.1% for HPV DNA testing, and 73.1%, 97.8%, 16.3% for HPV mRNA testing. These estimates for triaging of HPV DNA-positive women with liquid-based cytology were 64.4%, 98.8%, and 19.0%, respectively, and slightly better for liquid-based cytology triage of HPV mRNA-positive women, at 71.8%, 98.9%, and 22.1%. Conclusion A triaging strategy based on HPV genotyping and liquid-based cytology for those positive only for the less oncogenic HPV types had test characteristics comparable with that of liquid-based cytology triage. The HPV mRNA detection-based strategies had non-significant advantages over the HPV DNA detection-based strategies.

Can Human Papillomavirus DNA Testing Substitute for Cytology in the Detection of High-Grade Cervical Lesions?

2004 ◽  
Vol 128 (3) ◽  
pp. 298-302
Author(s):  
Kyung-Ju Lee ◽  
Jae-Kwan Lee ◽  
Ho-Suk Saw
Keyword(s):  
Human Papillomavirus ◽  
Cervical Lesion ◽  
High Grade ◽  
Dna Testing ◽  
Cervical Lesions ◽  
Abnormal Cytology ◽  
Hpv Dna ◽  
Conventional Cytology ◽  
Hpv Dna Testing ◽  
Papillomavirus Dna

Abstract Context.—High-risk human papillomaviruses (HPVs) are causal factors of cervical carcinomas. Objective.—To evaluate the sensitivity and efficiency of HPV DNA testing in comparison with conventional cytology for detection of cervical intraepithelial neoplasia (CIN) and cancer. Design.—Both testing procedures were administered to 593 women, aged 14 to 88 years (average, 41.7 years), who were referred for abnormal cytology from January 2000 through December 2001 at Korea University Guro Hospital (Seoul, Korea). After histologic confirmation by either colposcopically directed biopsy or endocervical curettage, the efficiency of the detection methods for high-grade cervical lesion was evaluated for the following 3 data sets: HPV DNA testing, conventional cytology, and the 2 tests combined. Results.—The sensitivity, specificity, and positive predictive, and negative predictive values for the detection of CIN 2 or higher were 92.4%, 52.4%, 49.3%, and 93.2% for HPV DNA testing; 76.3%, 65.8%, 52.8%, and 84.7% for cytology; and 97.8%, 36.7%, 49.2%, and 97.3% for the combined tests. Among the 151 patients diagnosed with CIN 2 or CIN 3, 137 patients (90.7%) were HPV positive, 116 patients (76.8%) were proven to have abnormal cytology, and 147 patients (97.6%) were positive for either HPV DNA testing or cytology. The sensitivity values for HPV DNA testing and cytology were 97.9% (46/47) and 74.5% (35/47), respectively, for invasive cervical cancer detection, and the combined tests showed 100% (47/47) sensitivity. Depending on the patient's age and the grade of the cervical lesion, HPV DNA testing proved to be significantly more sensitive than cytology for the primary detection of cervical abnormalities (P < .001). Conclusion.—Human papillomavirus DNA testing for the detection of high-grade cervical lesions was more sensitive than cytology alone. In addition, the screening sensitivity can be further improved by combining cytology with HPV DNA testing. This approach is especially beneficial in detecting cancer precursors in women older than 60 years.

Human Papillomavirus DNA Testing as an Adjunct to Cytology in Cervical Screening Programs

2003 ◽  
Vol 127 (8) ◽  
pp. 959-968 ◽  
Author(s):  
Attila T. Lörincz ◽  
Ralph M. Richart
Keyword(s):  
High Grade ◽  
Dna Testing ◽  
Papanicolaou Test ◽  
Chain Reaction ◽  
Hpv Dna ◽  
Screening Programs ◽  
Hpv Dna Testing ◽  
Hybrid Capture 2 ◽  
Screening Intervals ◽  
Polymerase Chain

Abstract Our objective was to review current large studies of human papillomavirus (HPV) DNA testing as an adjunct to the Papanicolaou test for cervical cancer screening programs. We analyzed 10 large screening studies that used the Hybrid Capture 2 test and 3 studies that used the polymerase chain reaction test in a manner that enabled reliable estimates of accuracy for detecting or predicting high-grade cervical intraepithelial neoplasia (CIN). Most studies allowed comparison of HPV DNA and Papanicolaou testing and estimates of the performance of Papanicolaou and HPV DNA as combined tests. The studies were selected on the basis of a sufficient number of cases of high-grade CIN and cancer to provide meaningful statistical values. Investigators had to demonstrate the ability to generate reasonably reliable Hybrid Capture 2 or polymerase chain reaction data that were either minimally biased by nature of study design or that permitted analytical techniques for addressing issues of study bias to be applied. Studies had to provide data for the calculation of test sensitivity, specificity, predictive values, odds ratios, relative risks, confidence intervals, and other relevant measures. Final data were abstracted directly from published articles or estimated from descriptive statistics presented in the articles. In some studies, new analyses were performed from raw data supplied by the principal investigators. We concluded that HPV DNA testing was a more sensitive indicator for prevalent high-grade CIN than either conventional or liquid cytology. A combination of HPV DNA and Papanicolaou testing had almost 100% sensitivity and negative predictive value. The specificity of the combined tests was slightly lower than the specificity of the Papanicolaou test alone, but this decrease could potentially be offset by greater protection from neoplastic progression and cost savings available from extended screening intervals. One “double-negative” HPV DNA and Papanicolaou test indicated better prognostic assurance against risk of future CIN 3 than 3 subsequent negative conventional Papanicolaou tests and may safely allow 3-year screening intervals for such low-risk women.

Findings to Date From the ASCUS-LSIL Triage Study (ALTS)

2003 ◽  
Vol 127 (8) ◽  
pp. 946-949 ◽  
Author(s):  
Mark Schiffman ◽  
Diane Solomon
Keyword(s):  
Intraepithelial Neoplasia ◽  
The United States ◽  
Alternative Methods ◽  
Low Grade ◽  
High Grade ◽  
Dna Testing ◽  
Squamous Intraepithelial Lesion ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Intraepithelial Lesion

Abstract Controversy exists in the United States regarding the proper evaluation and management of low-grade squamous intraepithelial lesion (LSIL) and equivocal (atypical squamous cells of undetermined significance [ASCUS, now ASC-US]) cervical cytologic interpretations. To address this issue, the National Cancer Institute initiated the ASCUS-LSIL Triage Study (ALTS). ALTS is a multicenter, randomized clinical trial designed to evaluate 3 alternative methods of management, namely, immediate colposcopy, cytologic follow-up, and triage by human papillomavirus (HPV) DNA testing. This article summarizes the major findings of ALTS that have been published to date. Patients with ASCUS (n = 3488) or LSIL (n = 1572) were randomly assigned to research arms between November 1996 and December 1998, and were monitored for 2 years. The disease outcome was histologic cervical intraepithelial neoplasia (CIN) 3/cancer. The prevalence of oncogenic HPV was too high to permit effective triage of LSIL using HPV DNA testing by Hybrid Capture 2. However, for the women referred with a cytologic interpretation of ASCUS, HPV triage proved useful, with sensitivity equivalent to immediate colposcopy and a halving of colposcopic referrals. Among older women with ASCUS, HPV testing remained sensitive for detecting CIN 3 and cancer, but the referral percentage was dramatically lower compared to younger women. ALTS yielded insight into the performance of cytology and histopathology; experienced pathologists differed significantly in their interpretations of cervical abnormalities, especially histologic CIN 1 and cytologic ASCUS. Nonetheless, it was possible to distinguish a relatively uncommon type of ASCUS, equivocal for high-grade squamous intraepithelial lesion, that has a high positive predictive value for identifying women with underlying high-grade CIN. Many additional analyses are underway.

Possible causes of low sensitivity of HPV-DNA testing for CIN2/3

2004 ◽  
Vol 83 (2) ◽  
pp. 217-218
Author(s):  
Andrea Guyot ◽  
John Fox ◽  
Shakir Karim ◽  
May s. Kyi
Keyword(s):  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Low Sensitivity

HPV DNA testing: clinical boon or boondoggle?

The Lancet ◽  
1995 ◽  
Vol 346 (8977) ◽  
pp. 717-719 ◽  
Author(s):  
J Thomas Cox
Keyword(s):  
Dna Testing ◽  
Hpv Dna ◽  
Hpv Dna Testing
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