title: Human papillomavirus DNA detection and histological findings in women referred for atypical glandular cells or adenocarcinoma in situ in their Pap smears.
abstract: OBJECTIVE
  To evaluate the association between high-risk human papillomavirus (HPV) DNA detection and histological diagnosis in women referred for atypical glandular cells (AGC) or adenocarcinoma in situ (AIS) at Pap smear.
  
  
  METHODS
  In this cross-sectional study, 146 women referred for AGC (124), AGC with high-grade squamous intraepithelial lesion (HSIL) (15), or AIS (7) were tested for HPV DNA using Hybrid Capture II (HC II). All women underwent colposcopic examination, and cervical biopsy was performed for 95 patients. Fifty-one women referred due to AGC with normal colposcopy and normal second Pap smear were scheduled for control visits every 4 months.
  
  
  RESULTS
  The overall prevalence of HPV DNA was 38%. HPV DNA was detected in 93% of the women with HSIL associated with AGC and in 71% of women with AIS Pap smear, being significantly higher when compared with the prevalence (29%) in women with AGC alone. Forty-five women (30.8%) had clinically significant histological lesions (CIN 2 or worse). High-risk HPV DNA was detected in only 16% of the women without significant abnormalities in biopsy, in contrast to 96% of those who had CIN 2 or CIN 3 and 75% of women with AIS. Eighty-five percent of women with invasive cervical carcinoma (squamous or adenocarcinoma) tested positive for HPV DNA. HPV DNA detection was significantly associated with histological diagnosis of CIN 2 or worse, with an odds ratio (OR) = 51.8 (95% CI 14.3-199.9).
  
  
  CONCLUSIONS
  HPV DNA detection was strongly associated with the severity of cervical lesion (CIN 2 or worse) in women referred for AGC or AIS in their Pap smear. These data implicate the use of HPV testing in triage of women with AGC Pap smears.
authors.affiliation: Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (UNICAMP), Rua Alexander Fleming 101, CEP:13083-970, Campinas, SP, Brazil.
authors.forename: Sophie Françoise Mauricette
authors.initials: SF
authors.lastname: Derchain
authors.forename: Silvia Helena
authors.initials: SH
authors.lastname: Rabelo-Santos
authors.forename: Luis Otávio
authors.initials: LO
authors.lastname: Sarian
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Zeferino
authors.forename: Eliane Regina
authors.initials: ER
authors.lastname: de Oliveira Zambeli
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: do Amaral Westin
authors.forename: Liliana Aparecida Lucci
authors.initials: LA
authors.lastname: de Angelo Andrade
authors.forename: Kari Juhani
authors.initials: KJ
authors.lastname: Syrjänen
mesh_terms: D001706:Biopsy; D003127:Colposcopy; D019092:Conization; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000821:virology*
chemical_list: D004279:DNA, Viral