title: High performance of a new PCR-based urine assay for HPV-DNA detection and genotyping.
abstract: Human papillomavirus (HPV) testing has been proposed as a means of replacing or supporting conventional cervical screening (Pap test). However, both methods require the collection of cervical samples. Urine sample is easier and more acceptable to collect and could be helpful in facilitating cervical cancer screening. The aim of this study was to evaluate the sensitivity and specificity of urine testing compared to conventional cervical smear testing using a PCR-based method with a new, designed specifically primer set. Paired cervical and first voided urine samples collected from 107 women infected with HIV were subjected to HPV-DNA detection and genotyping using a PCR-based assay and a restriction fragment length polymorphism method. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were calculated using the McNemar's test for differences. Concordance between tests was assessed using the Cohen's unweighted Kappa (k). HPV DNA was detected in 64.5% (95% CI: 55.1-73.1%) of both cytobrush and urine samples. High concordance rates of HPV-DNA detection (k = 0.96; 95% CI: 0.90-1.0) and of high risk-clade and low-risk genotyping in paired samples (k = 0.80; 95% CI: 0.67-0.92 and k = 0.74; 95% CI: 0.60-0.88, respectively) were observed. HPV-DNA detection in urine versus cervix testing revealed a sensitivity of 98.6% (95% CI: 93.1-99.9%) and a specificity of 97.4% (95% CI: 87.7-99.9%), with a very high NPV (97.4%; 95% CI: 87.7-99.9%). The PCR-based assay utilized in this study proved highly sensitive and specific for HPV-DNA detection and genotyping in urine samples. These data suggest that a urine-based assay would be a suitable and effective tool for epidemiological surveillance and, most of all, screening programs.
authors.affiliation: Department of Biomedical Sciences for Health, University of Milan, Milan, Italy. elisabetta.tanzi@unimi.it
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Tanzi
authors.forename: Silvia
authors.initials: S
authors.lastname: Bianchi
authors.forename: Maria Michela
authors.initials: MM
authors.lastname: Fasolo
authors.forename: Elena R
authors.initials: ER
authors.lastname: Frati
authors.forename: Francesca
authors.initials: F
authors.lastname: Mazza
authors.forename: Marianna
authors.initials: M
authors.lastname: Martinelli
authors.forename: Daniela
authors.initials: D
authors.lastname: Colzani
authors.forename: Rosangela
authors.initials: R
authors.lastname: Beretta
authors.forename: Alessandra
authors.initials: A
authors.lastname: Zappa
authors.forename: Giovanna
authors.initials: G
authors.lastname: Orlando
mesh_terms: D000328:Adult; D000368:Aged; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology*; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014556:Urine / Q000821:virology*; D014773:Virology / Q000379:methods; D055815:Young Adult
chemical_list: D004279:DNA, Viral