Iftner Thomas, Germ Liesje, Swoyer Ryan, Kjaer Susanne Kruger, Breugelmans J Gabrielle, Munk Christian, Stubenrauch Frank, Antonello Joseph, Bryan Janine T, Taddeo Frank J
University Hospital of Tübingen, Tübingen, Germany.
J Clin Microbiol. 2009 Jul;47(7):2106-13. doi: 10.1128/JCM.01907-08. Epub 2009 May 6.
Human papillomavirus (HPV) DNA genotyping is an essential test to establish efficacy in HPV vaccine clinical trials and HPV prevalence in natural history studies. A number of HPV DNA genotyping methods have been cited in the literature, but the comparability of the outcomes from the different methods has not been well characterized. Clinically, cytology is used to establish possible HPV infection. We evaluated the sensitivity and specificity of HPV multiplex PCR assays compared to those of the testing scheme of the Hybrid Capture II (HCII) assay followed by an HPV PCR/line hybridization assay (HCII-LiPA v2). SurePath residual samples were split into two aliquots. One aliquot was subjected to HCII testing followed by DNA extraction and LiPA v2 genotyping. The second aliquot was shipped to a second laboratory, where DNA was extracted and HPV multiplex PCR testing was performed. Comparisons were evaluated for 15 HPV types common in both assays. A slightly higher proportion of samples tested positive by the HPV multiplex PCR than by the HCII-LiPA v2 assay. The sensitivities of the multiplex PCR assay relative to those of the HCII-LiPA v2 assay for HPV types 6, 11, 16, and 18, for example, were 0.806, 0.646, 0.920, and 0.860, respectively; the specificities were 0.986, 0.998, 0.960, and 0.986, respectively. The overall comparability of detection of the 15 HPV types was quite high. Analyses of DNA genotype testing compared to cytology results demonstrated a significant discordance between cytology-negative (normal) and HPV DNA-positive results. This demonstrates the challenges of cytological diagnosis and the possibility that a significant number of HPV-infected cells may appear cytologically normal.
人乳头瘤病毒(HPV)DNA基因分型是确定HPV疫苗临床试验疗效以及自然史研究中HPV流行情况的一项重要检测。文献中已提及多种HPV DNA基因分型方法,但不同方法的结果可比性尚未得到充分描述。临床上,细胞学检查用于确定是否可能感染HPV。我们评估了HPV多重PCR检测与杂交捕获二代(HCII)检测方案随后进行HPV PCR/线性探针杂交检测(HCII-LiPA v2)的敏感性和特异性。SurePath剩余样本被分成两份。一份进行HCII检测,随后进行DNA提取和LiPA v2基因分型。另一份样本被送往第二个实验室,在那里提取DNA并进行HPV多重PCR检测。对两种检测中常见的15种HPV类型进行了比较评估。HPV多重PCR检测呈阳性的样本比例略高于HCII-LiPA v2检测。例如,多重PCR检测相对于HCII-LiPA v2检测对HPV 6型、11型、16型和18型的敏感性分别为0.806、0.646、0.920和0.860;特异性分别为0.986、0.998、0.960和0.986。15种HPV类型检测的总体可比性相当高。与细胞学结果相比,DNA基因分型检测分析表明,细胞学阴性(正常)结果与HPV DNA阳性结果之间存在显著不一致。这表明了细胞学诊断的挑战,以及大量HPV感染细胞在细胞学上可能表现正常的可能性。