Department of Cytopathology, Attikon University Hospital, University of Athens Med, Sch, Athens, Greece.
BMC Cancer. 2010 Feb 22;10:53. doi: 10.1186/1471-2407-10-53.
We evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women.
All women with liquid-based cytology performed at a University Hospital between 2000 and 2003 were included. The Hybrid Capture 2 (HC2) kit and in house Polymerase Chain Reaction (PCR) were used for HPV DNA detection. Cervical biopsy was performed for women with ASCUS+ cytology, HPV detection, or abnormal colposcopy. Positive (PLR) and negative (NLR) likelihood ratios were calculated for cytology and HPV molecular testing for the prediction of CIN2 and greater histology.
Of the 1270 women evaluated 241 (18.5%) had abnormal cytology. Cytology diagnosed high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma in 21(1.7%) cases whereas 26 (2%) women had CIN2+ or greater histology. PCR detected HPV in 397/1270 (31.3%) and HC2 in 260/1270 (20.4%) samples. Both molecular tests exhibited high reproducibility (Cohen's kappa value 0.691, 95% CI: 0.664 - 0.718). Positive likelihood ratios (PLR) of 9.4, 3.8 and 3.4 and negative likelihood ratios of 0.13, 0.21, and 0 were noted for >or= LSIL, any positive HC2 or any positive PCR-HPV testing, for predicting CIN2+ histology, respectively. All CIN 3+ lesions harbored high risk oncogenic HPV type infections.
HPV infection was found in a large proportion of this population and was associated with CIN 2/3 lesions and infiltrating carcinomas. Thin prep testing and HPV detection by HC2 or PCR performed very well with regards to identifying high grade lesions in an environment with experienced examiners.
我们评估了两种 HPV 检测的分子方法，并在希腊妇女的大样本中评估了它们与细胞学和组织学诊断的相关性。
所有在 2000 年至 2003 年间在一家大学医院进行液基细胞学检查的女性均被纳入研究。使用杂交捕获 2（HC2）试剂盒和内部聚合酶链反应（PCR）进行 HPV DNA 检测。对于 ASCUS+细胞学、HPV 检测或异常阴道镜检查的女性，进行宫颈活检。计算了细胞学和 HPV 分子检测对预测 CIN2 及以上组织学的阳性（PLR）和阴性（NLR）似然比。
在评估的 1270 名女性中，有 241 名（18.5%）存在异常细胞学。细胞学诊断高级别鳞状上皮内病变（HSIL）或浸润性癌 21 例（1.7%），而 26 例（2%）女性存在 CIN2+或更高级别的组织学病变。PCR 在 1270 例样本中的 397 例（31.3%）和 HC2 在 1270 例样本中的 260 例（20.4%）中检测到 HPV。两种分子检测均具有较高的重现性（Cohen's kappa 值 0.691，95%CI：0.664-0.718）。对于预测 CIN2+组织学，≥LSIL、任何阳性 HC2 或任何阳性 PCR-HPV 检测的阳性似然比（PLR）分别为 9.4、3.8 和 3.4，阴性似然比（NLR）分别为 0.13、0.21 和 0。所有 CIN3+病变均携带高危致癌 HPV 型感染。
在该人群中发现了很大一部分 HPV 感染，与 CIN 2/3 病变和浸润性癌相关。在经验丰富的检查者环境中，使用薄型预处理检测和 HC2 或 PCR 进行 HPV 检测对于识别高级别病变效果非常好。
