Correlation of manual screening and automated (AutoPap 300) analysis of conventional cervicovaginal smears with HPV typing using Digene HC II assay.
Efforts to improve the accuracy and efficacy of diagnosis of cervical cancer and its precursor lesions have prompted the development of new technologies, including several automated screening systems and human papillomavirus (HPV) hybrid capture assay. In this study of 89 conventional cervicovaginal (Papanicolaou [Pap]) smears, diagnoses based on manual screening are correlated with analyses by the AutoPap 300 primary screening system and results of the Digene HPV hybrid capture II assay. We found that (1) the AutoPap system did not "miss" (place in the "no further review" category) any of the high-risk HPV DNA positive cases, (2) quintile assignments by the AutoPap system did not reliably predict the presence or absence of high-risk HPV DNA, (3) cases of low-grade squamous intraepithelial lesion (LGSIL) were associated with high-risk rather than low-risk HPV genotypes, (4) diagnoses of atypical squamous cells of undetermined significance (ASCUS) and above were more frequent in smears from patients whose cervicovaginal specimens tested positive rather than negative for high-risk HPV DNA (37 of 45 vs 14 of 44) by the Digene HPV hybrid capture II assay, and (5) there was a high incidence of high-risk HPV DNA among women whose smears did not show cytomorphologic changes of high-grade squamous intraepithelial lesion (HGSIL). These findings emphasize that high-risk HPV DNA is an indication of risk for HGSIL, not the equivalent for it.
Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. walts@cshs.org
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D000293:Adolescent; D000328:Adult; D004279:DNA, Viral / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis; D012680:Sensitivity and Specificity; D014412:Tumor Virus Infections / Q000175:diagnosis; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D014626:Vaginal Smears
D004279:DNA, Viral