Yarkin Fugen, Chauvin Sara, Konomi Nami, Wang Wayne, Mo Richard, Bauchman Gail, Diaz Angela, Burstein David, Szporn Arnold, Hauptman Eileen, Zhang David Y
Department of Pathology, Mount Sinai School of Medicine, New York University, New York, New York, USA.
Acta Cytol. 2003 May-Jun;47(3):450-6. doi: 10.1159/000326549.
To determine the feasibility and sensitivity of detecting human papillomavirus (HPV) in specimens collected in Cytyc PreservCyt fluid (Boxborough, Massachusetts, U.S.A.) using ligation-dependent polymerase chain reaction (LD-PCR) and to demonstrate the diagnostic value of HPV DNA testing as an adjunct to cytology in the detection of cervical squamous intraepithelial lesions (SIL), especially in cases of atypical squamous cells of undetermined significance (ASCUS).
LD-PCR is a recently invented DNA amplification technology that utilizes a capture probe for target isolation and 2 hemiprobes for target detection. The hemiprobes are designed in such a way that when they hybridize to their target, the 5' end of one probe and the 3' end of the other probe are brought together. Two hemiprobes can then be ligated into a full probe that can serve as a template for PCR amplification. A total of 94 cervical specimens were collected in cytologic fluid and tested with LD-PCR. The results were compared with those of the Digene Hybrid Capture II assay (HC II) (Beltville, Maryland, U.S.A.) and consensus PCR.
The overall sensitivity for detecting HPV was 41.5% (39/94) by LD-PCR, 50% (47/94) by consensus PCR and 37.2% (35/94) by HC II. The prevalence of HPV by HC II, consensus PCR and LD-PCR were 87.5%, 100% and 87.5% in the high grade SIL group; 100%, 90.9% and 90.9% in the low grade SIL group; 30%, 52.5% and 40% in the ASCUS group; and 14.2%, 22.8% and 17.1% in women with normal cytology. These results indicate that all 3 methods have similar sensitivity in patients with SIL. However, there is greater variation in detection rates in the ASCUS and normal cytology groups.
LD-PCR is a useful method of detecting HPV in liquid-based gynecologic cytologic preservatives, and HPV testing as a method adjunct to the liquid-based Pap test could be useful in detecting SILs, especially for the management of patients with ASCUS.
确定使用连接依赖型聚合酶链反应（LD-PCR）检测美国马萨诸塞州博克斯伯勒市赛迪科公司PreservCyt液中收集的标本中人类乳头瘤病毒（HPV）的可行性和敏感性，并证明HPV DNA检测作为细胞学辅助手段在检测宫颈鳞状上皮内病变（SIL），尤其是意义不明确的非典型鳞状细胞（ASCUS）病例中的诊断价值。
LD-PCR是一项最近发明的DNA扩增技术，它利用一个捕获探针进行靶标分离，两个半探针进行靶标检测。半探针的设计方式是，当它们与靶标杂交时，一个探针的5'端和另一个探针的3'端会靠近在一起。然后两个半探针可以连接成一个完整的探针，作为PCR扩增的模板。总共94份宫颈标本收集于细胞液中，并用LD-PCR进行检测。结果与美国马里兰州贝尔茨维尔市迪金公司的杂交捕获II代检测法（HC II）和共识PCR的结果进行比较。
LD-PCR检测HPV的总体敏感性为41.5%（39/94），共识PCR为50%（47/94），HC II为37.2%（35/94）。HC II、共识PCR和LD-PCR检测HPV的患病率在高级别SIL组分别为87.5%、100%和87.5%；低级别SIL组分别为100%、90.9%和90.9%；ASCUS组分别为30%、52.5%和40%；细胞学正常的女性分别为14.2%、22.8%和17.1%。这些结果表明，所有3种方法在SIL患者中的敏感性相似。然而，ASCUS组和细胞学正常组的检测率差异更大。
LD-PCR是检测液基妇科细胞保存剂中HPV的一种有用方法，HPV检测作为液基巴氏试验的辅助方法，在检测SIL方面可能有用，尤其是在管理ASCUS患者方面。
