Performance of HPV DNA testing in the follow-up after treatment of high-grade cervical lesions, adenocarcinoma in situ (AIS) and microinvasive carcinoma

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.

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Cervical cytology with a diagnosis of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H): a follow-up study with corresponding histology and significance of predicting dysplasia by human papillomavirus (HPV) DNA testing

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-013-3015-5 ◽

2013 ◽

Vol 289 (3) ◽

pp. 645-648 ◽

Cited By ~ 9

Author(s):

Syed M. Gilani ◽

Randy Tashjian ◽

Lamia Fathallah

Keyword(s):

Human Papillomavirus ◽

High Grade ◽

Dna Testing ◽

Squamous Intraepithelial Lesion ◽

Hpv Dna ◽

Squamous Cells ◽

Follow Up Study ◽

Hpv Dna Testing ◽

Intraepithelial Lesion

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HPV DNA patterns and disease implications in the follow-up of patients treated for HPV16 high-grade carcinoma in situ

Journal of Medical Virology ◽

10.1002/jmv.20567 ◽

2006 ◽

Vol 78 (4) ◽

pp. 494-500 ◽

Cited By ~ 9

Author(s):

Monica Cricca ◽

Simona Venturoli ◽

Antonio Maria Morselli-Labate ◽

Silvano Costa ◽

Donatella Santini ◽

...

Keyword(s):

Carcinoma In Situ ◽

High Grade ◽

Hpv Dna ◽

High Grade Carcinoma

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Loop Electrosurgical Excision Procedure in Cervical Intraepithelial Neoplasia

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v11i1.16291 ◽

2016 ◽

Vol 11 (1) ◽

pp. 58-61

Author(s):

Rima Maharjan ◽

BK Thapa ◽

Neershobha Chitrakar ◽

Jitendra Pariyar ◽

Isha Shrestha ◽

...

Keyword(s):

Squamous Cell ◽

Simple Procedure ◽

Pap Test ◽

Intraepithelial Neoplasia ◽

Final Diagnosis ◽

Invasive Squamous Cell Carcinoma ◽

Adenocarcinoma In Situ ◽

Cervical Lesions

Aims: To evaluate the treatment outcome and acceptance of LEEP in precancerous cervical lesions.Methods: This is a descriptive study performed in Gynecology Department of Civil Service Hospital, from August 2014 - December 2015 in 28 cases that underwent LEEP forCIN. LEEP was performed as day care procedure under intravenous anesthesia and patient was sent home six hours after procedure. Follow up and further treatment was done after final histopathological reports.Results: Highest percentage ofCIN, 32.14% (9) was seen among 30-39 years age with 16 (57.14%) of parity three and more. 17 (60.71%) presented clinic with symptoms (lower abdominal, backpain, pervaginal discharge) while 11 (39.28%) were diagnosed from routine Pap test. Histopathology revealed four (14.28%)CIN1, eight (28.57%)CIN2, 11(39.28%)CIN3, two adenocarcinoma in situ, one of invasive squamous cell carcinoma, chronic cervicitis and atrophic change with no dysplasia. Margins were negative (satisfactory) in 20 (71.42%) and positive in eight (28.57%) with endocervical involvement in two that required second LEEP while one underwent radical hysterectomy for final diagnosis of invasive squamous cell carcinoma.Conclusions: Hysterectomy is a radical procedure for preinvasive cervical lesions that can be treated with simple procedure like LEEP that saves time and financial resources.

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HPV DNA testing detects more cervical lesions than cytology

Nature Reviews Clinical Oncology ◽

10.1038/nrclinonc.2012.231 ◽

2012 ◽

Vol 10 (2) ◽

pp. 64-64

Keyword(s):

Dna Testing ◽

Cervical Lesions ◽

Hpv Dna ◽

Hpv Dna Testing

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The evaluation of human papillomavirus DNA testing in primary screening for cervical lesions in a large Japanese population

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200605000-00009 ◽

2006 ◽

Vol 16 (3) ◽

pp. 1007-1013 ◽

Cited By ~ 12

Author(s):

M. Inoue ◽

J. Sakaguchi ◽

T. Sasagawa ◽

M. Tango

Keyword(s):

Human Papillomavirus ◽

High Risk ◽

Single Type ◽

Dna Testing ◽

Cervical Lesions ◽

Papanicolaou Test ◽

Histologic Diagnosis ◽

Hpv Dna ◽

Hpv Dna Testing ◽

High Risk Hpv

To examine the utility of human papillomavirus (HPV) DNA testing for the screening of cervical cancer and its precursors, a prospective cohort study was performed in which a total of 8156 women with a median age of 36 years were enrolled. Two smear samples scraped from the uterine cervix were served for Papanicolaou test and HPV DNA testing (Hybrid Capture-II system). HPV-positive samples were further examined for HPV subtype using a DNA microarry chip. Women with cytologic abnormality or those with high-risk HPV DNA were further examined by colposcopy to determine histologic diagnosis. High-risk HPV DNA was detected in 11% of the general population, with higher prevalence of specific types, including 52, 16, 58, 51, 56, and 18. As expected, younger women were likely to have increased frequency of HPV infection. Notably, HPV DNA testing detected all 45 cases of cervical intraepithelial neoplasia (CIN) 3, while cytologic findings were negative in 6 of these cases. It is of particular interest that CIN was commonly associated with multiple HPV types, while invasive cancers had a single type of HPV. In terms of both sensitivity and positive predictive value in detecting the CIN, HPV DNA testing is superior to cytology. However, most importantly, HPV DNA testing in combination with cytology significantly improved the efficacy to CIN screening.

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