scholarly journals The outcome of colposcopy in women attending with persistent postcoital bleeding and negative HPV-DNA test

2021 ◽  
Vol 8 (2) ◽  
pp. 97-100
Author(s):  
Mehmet Bayrak ◽  
Hakan Ozan
Keyword(s):  
Pap Smear ◽  
Cervical Dysplasia ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Dna Test ◽  
Hpv Dna ◽  
Pap Smear Test ◽  
Smear Test ◽  
Hpv Dna Test ◽  
Postcoital Bleeding

Objective: Women with postcoital bleeding (PCB) are recommended to be evaluated by colposcopy even if cytology is negative. Human papillomavirus (HPV) testing increases the detection of cervical intraepithelial neoplasia or worse compared to the Pap smear test. We aimed to determine the incidence of cervical pathology among women with persistent PCB with a negative Pap smear or HPV-DNA test. Our study, therefore, questions the place of HPV DNA test in women with PCB. Material and Methods: The clinical data of 212 women with persistent PCB and negative cytology or negative HPV DNA test referred to colposcopy, between January 2010 and June 2019, were retrospectively evaluated. Results: Among the 212 PCB patients, 161 (75.9%) were cytology negative and 51 (24.1%) were HPV DNA test (n=40) or co-test (n=11)  (negative for HPV DNA test and cytology) negative. There were no cases of invasive cancer. The women referred with negative cytology were more likely than those with negative HPV DNA to have CIN (21/161 (13%),  1/51 (1.9%) p=0.042. Seven women (4.3%) were diagnosed with high-grade cervical dysplasia in the negative cytology group. None of the patients in the HPV DNA negative group was diagnosed with high-grade cervical dysplasia. Conclusion: Our data show that a normal Pap smear cytology in women with PCB does not rule out the possibility of  HSIL. HPV DNA testing is a useful triage test to determine if colposcopy referral is required in the context of post-coital bleeding with negative smear test.

scholarly journals Efficiency of HPV DNA Test versus Pap Smear in the Screening of Cervical Cancer

2018 ◽  
Vol 1 (2) ◽  
pp. 9-13
Author(s):  
Renee Pradhan ◽  
U. Pant ◽  
B. Aryal
Keyword(s):  
Cervical Cancer ◽  
Cervical Intraepithelial Neoplasia ◽  
Pap Smear ◽  
Intraepithelial Neoplasia ◽  
Cervical Neoplasia ◽  
Hpv Testing ◽  
Dna Test ◽  
Hpv Dna ◽  
Smear Testing ◽  
Hpv Dna Test

Introduction: Cancer cervix is a common genital cancer. Human papillomavirus is the main cause of cervical cancer because of the strong association of certain HPV genotypes and the development of cervical cancer and its precursor lesions, cervical intraepithelial neoplasia CIN 2 or CIN3. Methods: The study was conducted on 180 gynecological patients seen at the outpatient department of Manipal Hospital, Bangalore. A comparative study of HPV DNA test with Pap smear in the screening of cervical neoplasia was carried out over the period of 24 months from August 2011 to June 2013. Results: The incidence of cervical cancer and its associated mortality has declined in recent years, largely due to the widespread implementation of screening programs by Pap smear testing. The management and the prevention of cervical cancer should change with HPV DNA testing for high risk HPV, which is more sensitive than pap smear testing. Infection of cervix with HPV is necessary to cause cervical neoplasia and cervical cancer. Persistent infection with HPV is required for the development of cervical dysplasia and invasive cervical cancer. Conclusions: HPV testing alone for primary screening appears promising in women aged 30 years and older as this group is at greatest risk of developing CIN 3. As compared with Pap testing, HPV testing has greater sensitivity for detection of cervical intraepithelial neoplasia.

Relevance of the Pap Test: A Report of HPV-DNA Test-Negative High-Grade Squamous Intraepithelial Lesions of the Female Lower Genital Tract

2016 ◽  
Vol 60 (5) ◽  
pp. 445-450 ◽  
Author(s):  
Yiang Hui ◽  
Katrine Hansen ◽  
Jayasimha Murthy ◽  
Danielle Chau ◽  
C. James Sung ◽  
...  
Keyword(s):  
High Risk ◽  
Pap Test ◽  
Human Papillomaviruses ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Cytologic Examination ◽  
Dna Test ◽  
Hpv Dna ◽  
Intraepithelial Lesions ◽  
Hpv Dna Test

Objective: A vast majority of cervicovaginal intraepithelial lesions are caused by high-risk human papillomaviruses (HPVs). The Pap test has been the sole method used for the screening of cervicovaginal squamous intraepithelial lesions (SIL). Recently, the FDA approved an HPV-DNA assay as a method of primary screening. We report on a series of FDA-approved HPV-DNA test-negative SIL with HPV genotyping, using an alternative method on the corresponding surgical biopsy specimens. Study Design: A retrospective review identified cytology-positive HPV-negative cases over a 15-month period at a tertiary care gynecologic oncology institution. Corresponding biopsies were reviewed and genotyped for high-risk HPVs. Results: Of the 18,200 total cases, 17 patients meeting the study criteria were selected with 27 surgical specimens corresponding to their cytologic diagnoses. Four patients with high-grade lesions were identified, 3 of whom (75%) were positive for HPV. One of these 4 patients (25%) showed high-grade SIL on biopsies from 4 separate sites in the cervix and vagina. Multiviral HPV infections were frequent. Conclusions: We discuss the relevance of cotesting for screening cervical SILs and emphasize that false-negative results are possible with the FDA-approved HPV screening assay, also in patients with high-grade SIL. These cases may be detectable by cytologic examination and this suggests that the Pap test remains an important diagnostic tool.

scholarly journals HPV DNA and Pap smear test results in cases with and without cervical pathology

2011 ◽  
Author(s):  
Sabit Sinan Ozalp ◽  
Tercan Us ◽  
Emine Arslan ◽  
Tufan Oge ◽  
Nilgun Kasifoglu
Keyword(s):  
Pap Smear ◽  
Test Results ◽  
Hpv Dna ◽  
Pap Smear Test ◽  
Smear Test

scholarly journals Correlation between Cytology, HPV-DNA Test and Colposcopy in Evaluation of Cervical Intraepithelial Lesions

2014 ◽  
Vol 2 (2) ◽  
pp. 71-74
Author(s):  
Anuja Nanda ◽  
Neeta Bansal ◽  
Vineeta Gupta ◽  
Arti Sharma ◽  
Archna Tandon ◽  
...  
Keyword(s):  
Pap Smear ◽  
False Negative ◽  
Clinical Findings ◽  
Screening Methods ◽  
Dna Test ◽  
Hpv Dna ◽  
Cervical Intraepithelial Lesions ◽  
Set Up ◽  
Intraepithelial Lesions ◽  
Hpv Dna Test

ABSTRACT Objectives The present study was undertaken to correlate cytology, HPV-DNA test and colposcopy in evaluation of cervical intraepithelial lesions. Materials and methods Patients were subjected to Pap smear, HPV-DNA detection, colposcopy and directed cervical biopsy if required. The various screening methods were correlated and evaluated by standard statistical methods. Observations A total of 324 patients were included in the study. Colposcopy was done in 263, Pap smear in 214, HPVDNA in 100 and HPE in 116 patients. Sensitivity and specificity of Pap smear test, colposcopy and HPV-DNA testing were calculated to be 66.66, 93.54, 86.84, 86.32, 90 and 84.61% respectively. Their positive predictive value and negative value were 75, 90.60, 67.34, 95.28, 69.23 and 95.66% respectively. The percentage of false negative and false positive were calculated to be 33.33, 6.45, 8.95, 13.67, 10 and 15.38% respectively. Conclusion Various screening methods for evaluation of cervical intraepithelial lesions are complimentary to each other and need to be carried out depending on the clinical findings, patient's convenience and compliance, facilities and set-up available. How to cite this article Gupta V, Tandon A, Nanda A, Sharma A, Bansal N, Singhal M. Correlation between Cytology, HPV-DNA Test and Colposcopy in Evaluation of Cervical Intraepithelial Lesions. J South Asian Feder Menopause Soc 2014;2(2):71-74.

scholarly journals Role of the HPV DNA Test in Follow-up of Treated Cervical Intraepithelial Neoplasia in Bangladesh

2014 ◽  
Vol 15 (19) ◽  
pp. 8063-8067 ◽  
Author(s):  
Ashrafun Nessa ◽  
Mohammad Harun Ur Rashid ◽  
Munira Jahan ◽  
Noor-E Ferdous ◽  
Pervin Akhter Shamsun Nahar ◽  
...  
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Dna Test ◽  
Hpv Dna ◽  
Hpv Dna Test

scholarly journals The use of HPV-DNA testing combined with Pap smear in detection of pre-invasive disease of the cervix

2017 ◽  
Vol 6 (12) ◽  
pp. 5192
Author(s):  
Fayrouz A. Nwesar ◽  
Tawfik Abdel Salam T. ◽  
Marwa Hanafi M. ◽  
Layla K. Younis ◽  
Ziad S. Abou-Zeid ◽  
...  
Keyword(s):  
Pap Smear ◽  
Invasive Disease ◽  
Punch Biopsy ◽  
Dna Testing ◽  
Cancer Cervix ◽  
Major Health Problem ◽  
Dna Test ◽  
Hpv Dna ◽  
Hpv Dna Testing ◽  
Hpv Dna Test

Background: Cancer cervix constitutes a major health problem worldwide. It is one of the most common female malignancy in both incidence and mortality. Cancer cervix has many risk factors, the most important one is persistent infection with one of HPV high risk types. Its morbidity and mortality can be reduced by frequent screening and early diagnosis. So that, several studies have been conducted in recent years in order to find better tests for screening for pre-invasive disease of the cervix and so early intervention and better prognosis. This study aimed to compare the sensitivity of Pap test and HPV DNA test as screening tests for pre-invasive disease of the cervix.Methods: 100 females from those attending Alexandria University gynaecologic clinic for causes rather than cancer cervix were subjected to Pap smear and cervical swab for HPV-DNA testing at the same setting. Cases of HSIL or positive HPV were subjected to VIA test, colposcopy and cervical punch biopsy was taken if aceto-whitening of the cervix or any other abnormality was found. Cases with ASCUS or LSIL were re-smeared after 3-6 months, if persistent or progressive pathology, colposcopy and punch biopsy from acetowhite areas were taken.Results: 21 cases (21%) were HPV positive and 66 cases (66%) were positive for intraepithelial lesions (37% ASCUS, 18% LSIL and 11% HSIL) with re-smearing there were 3 persistent ASCUS cases (8.1%) and 5 LSIL cases (27.78%). Colposcopy done, and biopsies were taken from 10 HSIL cases (90.1%), 5 LSIL (27.8%), 3 ASCUS (8.1%) and 10 HPV positive cases (62.5%). With significant relationship between colposcopic findings and HPV-DNA positivity and abnormal cytology. Biopsies were 18; 14 were CIN I and 4 were CIN II.Conclusions: HPV-DNA positivity has positive association with HSIL. Pap smear is an easy cheap method for screening. HPV-DNA test is less sensitive than cytology as a method for screening.

scholarly journals Correlation of HPV-DNA Test with Cytology and Histology for the Diagnosis of Cervical Cancer and Precancerous Lesions in a Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 13 (1) ◽  
pp. 103-105
Author(s):  
Shamina Islam ◽  
Md Nizam Uddin ◽  
Nasima Akter ◽  
Tarana Tabashum ◽  
Maznun Us Sadakin ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Precancerous Lesion ◽  
Care Hospital ◽  
Hybrid Capture ◽  
Dna Test ◽  
Hpv Dna ◽  
Cancerous Lesion ◽  
Hybrid Capture 2 ◽  
Hpv Dna Test

Introduction: Cervical cancer is the second most prevalent cancer among women worldwide. High-Risk Human Papilloma virus (hr-HPV) is an established cause of cervical cancer and precancerous lesion. Studies have shown the relationship between the HPV-DNA test with cervical precancerous and cancerous lesion in diagnosing cervical cancer. This study aimed to correlate HPV-DNA test with both cytology and histology. Objective: To find out the correlation of HPV-DNA test with cytology and histology for the diagnosis of cervical precancerous and cancerous lesion. Materials and Methods: Cervical smears and DNA samples were collected from the selected patients attending the colposcopy clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) from July 2011 to April 2013. Biopsy was done on colposcopically positive cases and histopathology reports were obtained. Thus 99 histologically proven patients of cervical cancer and precancerous lesion were selected. Pap smear was carried out on these 99 patients. HPV-DNA test (Hybrid Capture-2 assay) was carried out on the same samples and viral loads were estimated. Results: Among the 99 cases, 28(28.28%) cases were positive with Hybrid Capture-2(HC-2) assay. Out of 60 cases of CIN-I (Cervical Intraepithelial Neoplasia-1), 7(11.7%) cases were positive with HC-2. Among others, 3(15.0%) cases of CIN-II were positive with HC-2. The viral load was very high in invasive SCC (squamous cell carcinoma) cases in contrast to other categories of histological and cytological diagnosis. A significant relationship was observed between HC-2 and histological diagnosis (P<0.005); and between HC-2 and Pap smear (P<0.005). Conclusion: Introduction of HC-2 where possible along with Pap smear would be highly effective in primary screening and subsequent follow up of cervical precancerous and cancerous lesion. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 103-105

scholarly journals Ανίχνευση της Ε7 ογκοπρωτεΐνης και του DNA του ιού των ανθρωπίνων θηλωμάτων ως μεθόδων δευτερογενούς πρόληψης του καρκίνου του τραχήλου της μήτρας

2017 ◽  
Author(s):  
Κίμων Χατζησταματίου
Keyword(s):  
High Risk ◽  
Sandwich Elisa ◽  
Intraepithelial Neoplasia ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Hpv 16 ◽  
Dna Test ◽  
Hpv Dna ◽  
Squamous Cells ◽  
Undetermined Significance ◽  
Hpv Dna Test

Η παρούσα διατριβή είχε ως στόχο την ανάπτυξη και αρχική διαγνωστική αξιολόγηση μίας νέας μεθόδου ανίχνευσης της Ε7 πρωτεΐνης του HPV ως μεθόδου διαλογής των HPV θετικών γυναικών προς κολποσκόπηση. Γυναίκες, 30-60 ετών υποβλήθηκαν σε λήψη κολποτραχηλικού επιχρίσματος, που εξετάστηκε κυτταρολογικά (κυτταρολογία υγρής φάσης) αλλά και ως προς την ανίχνευση high-risk (hr) HPV DNA, σύμφωνα με τη μέθοδο Multiplex Genotyping (MPG). Γυναίκες θετικές για τουλάχιστο μία από αυτές τις δοκιμασίες υποβλήθηκαν σε κολποσκόπηση και όπου χρειαζόταν, σε ιστοληψία. Σε έναν αριθμό από αυτές τις γυναίκες έγινε ανίχνευση της Ε7 πρωτεΐνης του HPV (sandwich ELISA) χρησιμοποιώντας πέντε διαφορετικές δοκιμασίες ανίχνευσης, που αντιστοιχούσαν σε διαφορετικό συνδυασμό τύπων HPV, τις εξής: recomWell HPV 16/18/45 KJhigh, recomWell HPV 39/51/56/59, recomWell HPV 16/31/33/35/52/58, recomWell HPV HR screen και recomWell HPV 16/18/45 KJlow. Σε 1.723 από τις 1.762 γυναίκες της μελέτης ο επιπολασμός hrHPV ήταν 17,7% και των τύπων HPV16/18, 9,6%. Η κυτταρολογία είχε αποτέλεσμα ASCUS+ (Atypical Squamous Cells of Undetermined Significance or worse) στο 7,6%. Τραχηλική Ενδοεπιθηλιακή Νεοπλασία βαθμού 2 ή χειρότερου (Cervical Intraepithelial Neoplasia grade 2 or worse – CIN2+) ανιχνεύθηκε σε 28 περιπτώσεις (1,6%). Η ευαισθησία της κυτταρολογίας (ASCUS+) και του HPV DNA test για την ανίχνευση CIN2+ ήταν 50,0% και 100,0% και η ειδικότητα 94,49% και 85,49% αντίστοιχα. Η προσέγγιση κατά την οποία παραπομπή προς κολποσκόπηση γίνονταν μόνο για HPV16/18 θετικές γυναίκες και από τις υπόλοιπες hrHPV θετικές μόνο σε όσες υπήρχε θετική κυτταρολογία παρουσίασε ευαισθησία 78,57% και θετική προγνωστική αξία 13,17%. Η ανάλυση, σχετικά με τη διαλογή των HPV θετικών γυναικών έγινε επί 1.473/1.723, για τις οποίες υπήρχε αποτέλεσμα για την Ε7 πρωτεΐνη. Στις HPV16/18 θετικές γυναίκες ανιχνεύθηκαν 16 CIN2+. Η μη διαλογή των γυναικών αυτών προς κολποσκόπηση παρουσίασε ευαισθησία 100,0%, θετική προγνωστική αξία 11,11% ενώ ο αριθμός των κολποσκοπήσεων που χρειάστηκε για την ανίχνευση μίας περίπτωσης CIN2+ ήταν 9,0. Η ευαισθησία ανίχνευσης της Ε7 πρωτεΐνης ως μεθόδου διαλογής των HPV16/18 θετικών γυναικών προς κολποσκόπηση ήταν 75,0-100,0% με θετική προγνωστική αξία 16,86-26,08% ενώ ο αριθμός κολποσκοπήσεων για τη διάγνωση μίας περίπτωσης CIN2+ ήταν 3,83-5,93, ανάλογα με την Ε7 δοκιμασία. Η κυτταρολογία ως μέθοδος διαλογής των HPV θετικών γυναικών, εκτός HPV16/18, στην ομάδα των οποίων ανιχνεύθηκαν 11 περιπτώσεις CIN2+, παρουσίασε ευαισθησία 45,45%, θετική προγνωστική αξία 27,77%, ενώ ο αριθμός των απαραίτητων κολποσκοπήσεων για τη διάγνωση μίας περίπτωσης CIN2+ ήταν 3,6. Οι τιμές αυτών των δεικτών για τις δοκιμασίες ανίχνευσης της Ε7 πρωτεΐνης ήταν 72,72-100,0%, 16,32-25,0% και 4,0 έως 6,12 ανάλογα με τη δοκιμασία. Συμπερασματικά, τα αποτελέσματα της διατριβής, υποστηρίζουν τη χρήση του HPV DNA test ως μεθόδου αρχικού ελέγχου για την πρόληψη του καρκίνου του τραχήλου της μήτρας, με ταυτόχρονη HPV16/18 τυποποίηση και κυτταρολογία για τις γυναίκες που είναι αρνητικές για HPV16/18 αλλά θετικές για κάποιον άλλο τύπο υψηλού κινδύνου του HPV. Επιπλέον, υποστηρίζεται η χρήση της ανίχνευσης της Ε7 πρωτεΐνης του HPV για τη διαλογή των HPV16/18 θετικών γυναικών προς κολποσκόπηση σε σχέση με τη μη διαλογή, αλλά και για τη διαλογή των HPV θετικών γυναικών για τύπους HPV εκτός των HPV16/18, σε σχέση με την κυτταρολογία.

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