title: DNA image cytometry and human papillomavirus (HPV) detection help to select smears at high risk of high-grade cervical lesions.
abstract: Three samples were submitted from women undergoing routine screening (n=910): two smears (one for routine cytology and one for DNA image cytometry) and a scrape for human papillomavirus (HPV) testing. DNA histograms were classified as suspect in cases of aneuploidy, polyploidy, and/or diploidy with a high proliferation rate. Follow-up was available in 239 cases. The primary end-point was the presence of a high-grade squamous intraepithelial lesion (HGSIL) at biopsy. Seventy women (7.7%) had a high-risk (HR) HPV infection and a suspect DNA profile. In 77 women with cytological abnormalities, 28 HGSILs were detected: four with a prior diagnosis of ASCUS (all HR-HPV infected including three with a suspect DNA profile), three with smears evocative of LGSIL (all with HR-HPV infection and a suspect DNA profile), and 21 with smears evocative of HGSIL (all with HR-HPV infection and 20 with a suspect DNA profile). During the follow-up period, out of 239 women with a cytologically normal smear at first entry, five developed a HGSIL; all were HR-HPV-positive and four had a suspect DNA profile at the first smear. HR-HPV detection alone gives a sensitivity of 100% for the detection of HGSIL, with a specificity of 84.3%, whereas DNA measurement associated with HPV testing significantly enhances the specificity to 95.4%. Thus, the combination of HPV testing and DNA measurement provides a highly sensitive and specific evaluation of the risk of HGSIL on cervical smears.
authors.affiliation: Laboratoire Pol Bouin, CHU Reims, France. mlorenzato@chu-reims.fr
authors.forename: M
authors.initials: M
authors.lastname: Lorenzato
authors.forename: C
authors.initials: C
authors.lastname: Clavel
authors.forename: M
authors.initials: M
authors.lastname: Masure
authors.forename: J M
authors.initials: JM
authors.lastname: Nou
authors.forename: D
authors.initials: D
authors.lastname: Bouttens
authors.forename: G
authors.initials: G
authors.lastname: Evrard
authors.forename: J P
authors.initials: JP
authors.lastname: Bory
authors.forename: B
authors.initials: B
authors.lastname: Maugard
authors.forename: C
authors.initials: C
authors.lastname: Quereux
authors.forename: P
authors.initials: P
authors.lastname: Birembaut
mesh_terms: D002584:Cervix Uteri / Q000473:pathology* / Q000821:virology*; D016009:Chi-Square Distribution; D003584:Cytological Techniques; D004247:DNA / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019044:Image Cytometry; D017403:In Situ Hybridization; D027383:Papillomaviridae / Q000302:isolation & purification*; D011003:Ploidies; D011237:Predictive Value of Tests; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology*
chemical_list: D004247:DNA