Can we detect cervical human papillomavirus (HPV) infection by cytomorphology alone? Diagnostic value of non-classic cytological signs of HPV effect in minimally abnormal Pap tests.
OBJECTIVE
Our aim was to assess the validity of non-classical cytological signs in minimally abnormal cervical smears for the prediction of HPV infection.


METHODS
164 ThinPrep monolayers were re-screened for mild nuclear changes, disorders of keratinisation, abortive koilocytes and 'measles cells', as well as degenerative changes. HPV DNA was detected by GP5+/6+ and MY09/MY11 consensus primer PCR assays.


RESULTS
Seventy six of 164 cases (46.3%) had HPV positivity by PCR. All cytomorphological features studied were significantly associated with the presence of HPV. Mild nuclear changes had 100% sensitivity and 100% negative predictive value for HPV infection.


CONCLUSIONS
Our results indicate that non-classic cytomorphological signs can improve the sensitivity of cytology for detecting HPV. Minimally abnormal Pap smears lacking mild nuclear changes (16%) in the present study--do not require further molecular HPV testing.
Bollmann
M
M
Institute of Pathology Bonn-Duisdorf, Bonn, Germany.
Bánkfalvi
A
A
Trosic
A
A
Speich
N
N
Schmittt
C
C
Bollmann
R
R
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003581:Cytodiagnosis / Q000379:methods / Q000706:statistics & numerical data; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005860:Germany, West / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014626:Vaginal Smears / Q000379:methods* / Q000706:statistics & numerical data
D004279:DNA, Viral