False-negative hybrid capture II results related to altered adhesion molecule distribution in women with atypical squamous cells pap smear results and tissue-based human papillomavirus-positive high-grade cervical intraepithelial neoplasia.
OBJECTIVE
We investigated the detection of high-risk human papillomavirus DNA with the Hybrid Capture II test (HCII; Digene Corporation, Beltsville, MD) and the presence and pattern of distribution of adhesion molecules in biopsy-proven high-grade neoplastic lesions containing high-risk HPV-DNA from women with ASC cytology results.


METHODS
We screened 4,600 women and performed colposcopy in 278 women with atypical squamous cells cytologic results. All women underwent HCII and tissue-based polymerase chain reaction analysis for high-risk HPV subtypes. Of 33 women with cervical intraepithelial neoplasia (CIN) 2 or worse biopsy results, 27 biopsy specimens contained sufficient tissue to perform immunohistochemical testing (pathologist blinded as to cytologic and HCII results) for adhesion molecules beta-catenin and 21 cases for E-cadherin.


RESULTS
Five of 27 specimens with CIN 2 or worse biopsy results (18.5%) had negative HCII results. All five specimens showed evidence of high-risk human papillomavirus by polymerase chain reaction analysis. All five showed full-thickness distribution via immunohistochemical staining for beta-catenin. There was sufficient tissue to examine four of five specimens for E-cadherin, and a full-thickness distribution also was documented.


CONCLUSIONS
Previous research linked false-negative cytologic results in women with high-grade CIN to altered adhesion molecule distribution and impaired exfoliation, and a similar phenomenon may be responsible for false-negative HCII results in women with atypical squamous cells cytologic results and high-grade CIN.
Lonky
Neal M
NM
Department of Obstetrics and Gynecology, Kaiser Permanente, Anaheim, CA, USA. Neal.M.Lonky@kp.org
Felix
Juan
J
Tsadik
Girma Wolde
GW
Lonky
Stewart
S