Combining HPV and MIB-1 tests reduces the number of colposcopies in women with equivocal cytology.
BACKGROUND
In this study the MIB-1 immunostaining pattern as an index of cellular proliferation was analyzed in smears diagnosed as borderline dyskaryosis in order to establish whether the combination of human papillomavirus testing and MIB-1 staining could resolve equivocal cytology.


METHODS
Conventional Pap smears of 108 women diagnosed as borderline dyskaryosis were stained with MIB-1 and the proliferation index was assessed. These women were evaluated by colposcopy, histological sampling, and human papillomavirus, semi-quantitative evaluated by hybrid Capture II test.


RESULTS
All 64 human papillomavirus- and MIB-1-negative women had no underlying high-grade cervical intraepithelial neoplasia or cervical cancer. Forty of the 104 women with normal histology or cervical intraepithelial neoplasia I were positive for human papillomavirus, compared to only one positive MIB-1 test (i.e. proliferation index of more than 35%).


CONCLUSIONS
Adding a MIB-1-test in human papillomavirus-positive women with equivocal cytology might reduce the number of colposcopies needed to predict > or = cervical intraepithelial neoplasia II. With this approach only four instead of 43 human papillomavirus-positive women would have been referred for colposcopy.
Wensveen
C W M
CW
Department of Gynaecology Oncology, Erasmus MC, Rotterdam, The Netherlands. c.wensveen@erasmusmc.nl
Kagie
M J
MJ
Veldhuizen
R W
RW
Trimbos
J B M Z
JB
Boon
M E
ME
D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D002455:Cell Division; D015331:Cohort Studies; D003127:Colposcopy; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis* / Q000276:immunology; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology / Q000821:virology
D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D004279:DNA, Viral; D019394:Ki-67 Antigen; C440408:MIB-1 antibody