Hybrid capture based human papillomavirus typing in cervical screening compared to cytology and histology.
BACKGROUND
Cervical cancer is frequently associated with infection from various types of human papillomavirus (HPV) with high a oncogenic potential (high-risk types). Commercial systems for HPV typing are available, but the question as to when HPV typing should be performed has not yet been solved.


OBJECTIVE
To assess the value of HPV typing in a clinical setting in a population with opportunistic screening.


METHODS
Cytology, histology and HPV status of 593 patients from a high-risk collective were evaluated retrospectively. For HPV typing, the hybrid capture (HC) system was used.


RESULTS
Infection with high-risk types of HPV was associated with more severe cervical lesions. Women with PAP III or PAP IIID who were infected with high-risk HPV were at increased risk for high-grade cervical lesions (CIN III+) (p = 0.006). Conization influenced HPV status: of 63 patients who were HPV high-risk positive before conization, 4 remained positive afterwards.


CONCLUSIONS
HC appears to be a useful system to triage women with PAP III or IIID and to detect patients with residual HPV infection after conization. However, because of high costs and no significant increase in the sensitivity of cytology, the use of HPV typing in routine cervical screening cannot be recommended in countries with opportunistic annual cytological screening.
Birner
P
P
Department of Gynecopathology and Cytology, University of Vienna, Austria. peter.birner@akh-wien.ac.at
Schindl
M
M
Stani
J
J
Oberhuber
G
G
Czerwenka
K
K
Vutuc
C
C
Breitenecker
G
G
D000328:Adult; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology*; D016009:Chi-Square Distribution; D019092:Conization; D004279:DNA, Viral / Q000032:analysis; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D008163:Luminescent Measurements; D008403:Mass Screening; D008679:Metaplasia; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014412:Tumor Virus Infections / Q000150:complications / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000209:etiology / Q000517:prevention & control*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000209:etiology / Q000517:prevention & control*
D004279:DNA, Viral