Parkkinen S, Syrjänen S, Syrjänen K, Yliskoski M, Tenhunen J, Mäntyjärvi R, Ranki M
Department of Clinical Microbiology, University of Kuopio, Finland.
Gynecol Oncol. 1988 Jun;30(2):251-64. doi: 10.1016/0090-8258(88)90031-5.
A series of 97 cervical smears and 69 directed punch biopsies derived from 84 consecutive women prospectively followed-up for cervical HPV (human papillomavirus) infections were studied using the sandwich hybridization and in situ hybridization techniques with HPV 16 DNA probes. The aim was to test the sensitivity and applicability of these two techniques in routine diagnosis of cervical HPV infections from smears. As a measure of specimen adequacy, the number of cells recovered in the cervical scrape was determined along with HPV 16 DNA in the sandwich hybridization test using human pro-alpha 2(I)-collagen gene probe. CIN (cervical intraepithelial neoplasia) was suggested in 56% of the patients by the Pap smear, and disclosed in 65% of the biopsies. HPV 16 DNA was present in 57% of cervical scrapes consistent with CIN, i.e., were of Pap smear classes III or IV. Forty percent of the scrapes not suggestive of CIN, i.e., Pap smear classes I or II, also contained HPV 16 DNA. The detection rate for HPV 16 DNA of the sandwich hybridization method was 89% of that of the in situ method in adequate scrapes, but only 43% in cell-poor specimens. The number of HPV 16 DNA-positive scrapes as compared with the total number of diagnoses obtained by studying also the biopsies was 31/36 (69 patients). The results indicate that the cervical scrape as a noninvasive specimen is applicable for screening of cervical HPV infections, and it can be studied with acceptable sensitivity by the rapid sandwich hybridization technique. However, if a punch biopsy is indicated it should be studied using the in situ hybridization technique that allows more sensitive detection of HPV DNA than any other hybridization method and enables the analysis of several HPV types in the same sample instead of only one HPV type in the scrapes.
采用夹心杂交和原位杂交技术，使用人乳头瘤病毒16型（HPV 16）DNA探针，对连续84名前瞻性随访宫颈HPV（人乳头瘤病毒）感染的女性的97份宫颈涂片和69份定向穿刺活检样本进行了研究。目的是测试这两种技术在宫颈HPV感染涂片常规诊断中的敏感性和适用性。作为样本充足性的衡量标准，在夹心杂交试验中，使用人原α2（I）-胶原基因探针测定宫颈刮片中回收的细胞数量以及HPV 16 DNA。巴氏涂片提示56%的患者存在宫颈上皮内瘤变（CIN），活检发现65%的患者存在该病变。57%与CIN一致的宫颈刮片（即巴氏涂片III或IV级）中存在HPV 16 DNA。40%未提示CIN的刮片（即巴氏涂片I或II级）也含有HPV 16 DNA。在细胞充足的刮片中，夹心杂交法对HPV 16 DNA的检测率是原位法的89%，但在细胞稀少的样本中仅为43%。通过研究活检样本，HPV 16 DNA阳性刮片数量与总诊断数之比为31/36（69例患者）。结果表明，宫颈刮片作为一种非侵入性样本适用于宫颈HPV感染的筛查，并且可以通过快速夹心杂交技术以可接受的敏感性进行研究。然而，如果需要进行穿刺活检，则应使用原位杂交技术进行研究，该技术比任何其他杂交方法都能更灵敏地检测HPV DNA，并且能够在同一样本中分析多种HPV类型，而不是仅在刮片中分析一种HPV类型。
