[Evaluation of the role of the HPV test in routine clinical practice: prospective study].
OBJECTIVE
To determine the incidence of papillomavirus and to asses the role a HPV DNA in screening of cervical intraepithelial neoplasia.


METHODS
Czech National Collaborative Trial.


METHODS
Department of Gynaecology and Obstetrics, Kladno Hospital, Department of Microbiology, KLINLAB, Prague, outpatient clinics (Kladno, Bruntál, Unhost').


METHODS
The study group includes of 3,264 women, their cervical scrapings were sent to KLINLAB during November 1996 to June 1998, because of abnormal results of primary screening. Patients with ASCUS, AGNUS, LSIL, HSIL and/or abnormal colposcopic findings were eligible for this study. Only completely filled in records of a subgroup of 1,158 patients were assessed for sensitivity and specificity for CIN in screening methods.


RESULTS
The overall sensitivity of cytology and basic colposcopy were 84.7% and 64.9% respectively. The overall sensitivity of HPV DNA testing was 66%. The sensitivity of cytology of women with minor cytological abnormities for major cervical disease (CIN 2/3 and microinvasive cancer) in this group of patients was only 35%. Combined cytology with HPV DNA test gave an increased sensitivity for major cervical disease of 83%.


CONCLUSIONS
153 (66.4%) of the cervical intraepithelial neoplasias grade 2/3 displayed negative and borderline or mild cytological changes. The combined use of cytology with HPV testing increased the sensitivity with a reduction of specificity. However, it is evident from these results that HPV DNA testing alone cannot be used as a diagnostic tool but could usefully improve the level of screening CIN in common clinical practice.
Holub
Z
Z
Gynek.-porod. oddĕlení Nemocnice Kladno.
Lukác
J
J
Chválová
M
M
Brozková
H
H
Nováková
M
M
Poustková
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002584:Cervix Uteri / Q000382:microbiology*; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014412:Tumor Virus Infections / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000382:microbiology*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000382:microbiology*
D004279:DNA, Viral