title: No confirmed case of human papillomavirus DNA-negative cervical intraepithelial neoplasia grade 3 or invasive primary cancer of the uterine cervix among 511 patients.
abstract: OBJECTIVE
  This study was undertaken to analyze the prevalence and peculiarities of high-grade cervical neoplasias that are not associated with human papillomavirus (HPV) DNA.
  
  
  METHODS
  Four hundred nineteen women with a first-time diagnosis of cervical intraepithelial neoplasia grade 3 and 92 women with cervical cancer were examined prospectively with a commercially available HPV DNA test. Negative samples were re-tested by polymerase chain reaction (PCR) with general and type-specific primers while the corresponding histology specimens were evaluated by immunohistochemistry.
  
  
  RESULTS
  Of the 511 cases examined, 14 were HPV DNA negative on initial analysis. Of these, 7 were found not to be high-grade cervical neoplasia on histologic review, 3 cases were found to contain high-risk HPV types by PCR, and 2 samples were found to be inadequate for analysis. The 2 remaining HPV-negative cases were FIGO stage III and IV tumors. Immunohistochemistry was consistent with a primary adenocarcinoma of the ovary in 1 case and a primary bladder tumor in the other, although a primary cancer of the cervix could not be ruled out completely.
  
  
  CONCLUSIONS
  After exclusion of inadequate samples and erroneous diagnoses, HPV DNA was associated with all confirmed cervical intraepithelial neoplasia grade 3 and primary cervical cancers.
authors.affiliation: Department of Gynaecologic Oncology, Medizinische Hochschule Hannover, Hannover, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Böhmer
authors.forename: Adriaan J C
authors.initials: AJ
authors.lastname: van den Brule
authors.forename: Oliver
authors.initials: O
authors.lastname: Brummer
authors.forename: ChrisJ L M
authors.initials: CL
authors.lastname: Meijer
authors.forename: K Ulrich
authors.initials: KU
authors.lastname: Petry
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000821:virology; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000235:genetics*; D016133:Polymerase Chain Reaction; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*
chemical_list: D004279:DNA, Viral