[The significance of the combined usage of cytology and the HPV test in cervical cancer screening].
BACKGROUND
In the United States, the combined usage of cytology and the HPV test is employed in cervical cancer screening, but, in Japan, only cytology is performed in most cases. We conducted a comparative analysis of histopathological diagnoses by colposcopy, cytology, and the HPV test, and evaluated the effectiveness of cytology and the significance of its combined use with the HPV test.


METHODS
We compared the detection rates using the test for high-risk HPV and cytology, which were conducted in cases with various histological diagnoses. The hybrid capture method was used in the HPV test. The blind test was conducted by 3 cytologists in 14 cases in which the cytological differed from the histological diagnosis by more than 2 classes.


RESULTS
There were 89 cases above class IIIb or CIN 3, and 26 cases were below class IIIa. A total of 107 cases were positive on the HPV-DNA test, and 8 cases were negative.


CONCLUSIONS
Cytology is essential as a morphological diagnostic method in cancer screening. In contrast, the HPV test detects the cause of cervical cancer. Therefore, the combined usage of cytology and the HPV test as initial screening for cervical cancer would facilitate the diagnosis of a premalignant lesion or early-stage cervical cancer more promptly and accurately.
Department of Clinical Laboratory, Juntendo-Urayasu University Hospital, Urayasu 279-0021, Japan. kina@juntendo-urayasu.jp
Katsunari
K
Kina
Kazuhisa
K
Ishi
Akane
A
Hashizume
Harumi
H
Saeki
Saori
S
Shiono
Fuyuko
F
Nagai
Michio
M
Nojima
D003581:Cytodiagnosis; D015344:DNA Probes, HPV; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000235:genetics*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
D015344:DNA Probes, HPV; D004279:DNA, Viral