title: Clinical, colposcopic and pathological characteristics of cervical and vaginal high-grade lesions negative for HPV by Hybrid Capture 2.
abstract: OBJECTIVE
  Less than 5% of women with cervical or vaginal biopsy proven high-grade squamous intraepithelial lesions (HG-SIL) show a negative Hybrid Capture 2 (HC2) result. We analyzed 1) human papillomavirus (HPV) genotypes by PCR in order to determine whether these cases represent infections by common or unusual types, and 2) the clinical, colposcopic and pathological differential characteristics of these patients.
  
  
  METHODS
  646 women with a histological diagnosis of HG-SIL and a HC2 test collected within 6 months prior to the diagnosis were identified. Patients with a negative HC2 result were selected. HPV was typed in the biopsy specimen in all by PCR using SPF10 and GP5+/6+ primers, and p16(INK4a) immunostaining was performed. The clinical and colposcopy findings of these women were compared with a control group of HG-SIL with positive HC2 result.
  
  
  RESULTS
  20 women (3.1%) with HG-SIL had a negative HC2. All biopsies were positive for p16(INK4). PCR analysis detected HPV types included in HC2 test in 55% of the cases, with an identical percentage of common viruses between women with relative light unit values above or below 0.40 (p=.361). False negative HC2 tests increased with age (p=.002) and were more frequent in patients with non satisfactory colposcopy or small sized lesions (p<.001).
  
  
  CONCLUSIONS
  A negative HC2 test is an infrequent event in women with HG-SIL. Common HPV types are identified in over half of the cases. Older women and patients with small lesions or non satisfactory colposcopy have a higher rate of HC2 negative results.
authors.affiliation: Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine-University of Barcelona, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: del Pino
authors.forename: Leonardo
authors.initials: L
authors.lastname: Rodriguez-Carunchio
authors.forename: Immaculada
authors.initials: I
authors.lastname: Alonso
authors.forename: Aureli
authors.initials: A
authors.lastname: Torné
authors.forename: Agata
authors.initials: A
authors.lastname: Rodriguez
authors.forename: Pere
authors.initials: P
authors.lastname: Fusté
authors.forename: Paola
authors.initials: P
authors.lastname: Castillo
authors.forename: Roser
authors.initials: R
authors.lastname: Nonell
authors.forename: Nadia
authors.initials: N
authors.lastname: Abu-Lhiga
authors.forename: Jaume
authors.initials: J
authors.lastname: Ordi
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D016022:Case-Control Studies; D003127:Colposcopy; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000473:pathology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D014625:Vaginal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000378:metabolism / Q000473:pathology* / Q000821:virology
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral; D009363:Neoplasm Proteins