title: Hybrid capture vs. PCR screening of cervical human papilloma virus infections. Cytological and histological associations in 1270 women.
abstract: BACKGROUND
  We evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women.
  
  
  METHODS
  All women with liquid-based cytology performed at a University Hospital between 2000 and 2003 were included. The Hybrid Capture 2 (HC2) kit and in house Polymerase Chain Reaction (PCR) were used for HPV DNA detection. Cervical biopsy was performed for women with ASCUS+ cytology, HPV detection, or abnormal colposcopy. Positive (PLR) and negative (NLR) likelihood ratios were calculated for cytology and HPV molecular testing for the prediction of CIN2 and greater histology.
  
  
  RESULTS
  Of the 1270 women evaluated 241 (18.5%) had abnormal cytology. Cytology diagnosed high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma in 21(1.7%) cases whereas 26 (2%) women had CIN2+ or greater histology. PCR detected HPV in 397/1270 (31.3%) and HC2 in 260/1270 (20.4%) samples. Both molecular tests exhibited high reproducibility (Cohen's kappa value 0.691, 95% CI: 0.664 - 0.718). Positive likelihood ratios (PLR) of 9.4, 3.8 and 3.4 and negative likelihood ratios of 0.13, 0.21, and 0 were noted for >or= LSIL, any positive HC2 or any positive PCR-HPV testing, for predicting CIN2+ histology, respectively. All CIN 3+ lesions harbored high risk oncogenic HPV type infections.
  
  
  CONCLUSIONS
  HPV infection was found in a large proportion of this population and was associated with CIN 2/3 lesions and infiltrating carcinomas. Thin prep testing and HPV detection by HC2 or PCR performed very well with regards to identifying high grade lesions in an environment with experienced examiners.
authors.affiliation: Department of Cytopathology, Attikon University Hospital, University of Athens Med, Sch, Athens, Greece.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsiodras
authors.forename: John
authors.initials: J
authors.lastname: Georgoulakis
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Chranioti
authors.forename: Zanis
authors.initials: Z
authors.lastname: Voulgaris
authors.forename: Amanda
authors.initials: A
authors.lastname: Psyrri
authors.forename: Angeliki
authors.initials: A
authors.lastname: Tsivilika
authors.forename: John
authors.initials: J
authors.lastname: Panayiotides
authors.forename: Petros
authors.initials: P
authors.lastname: Karakitsos
mesh_terms: D000328:Adult; D001706:Biopsy; D003127:Colposcopy / Q000379:methods; D003584:Cytological Techniques; D005260:Female; D006115:Greece; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000235:genetics*; D016133:Polymerase Chain Reaction / Q000379:methods*; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology*