title: Comparison of the effectiveness of cytodiagnostics, molecular identification of HPV HR and CINtecPLUS test to identify LG SIL and HG SIL.
abstract: OBJECTIVE
  Comparison of conventional cytodiagnostics with molecular identification of DNA and mRNA HPV HR, immunocytochemical test for suppressor protein P16 and nuclear Ki 67 to detect cervical pathology screening of the division to LG SIL and HG SIL.
  
  
  METHODS
  630 Pap smears were taken from women with suspected cervical pathology were submitted for analysis, together with 558 smears for the presence of DNA HPV HR, 421 swabs for the presence of mRNA HPV HR, 86 swabs for the presence of suppressor protein P16 and nuclear Ki 67. In all of the women standard colposcopy with biopsy and endocervical abrasion were performed.
  
  
  METHODS
  The study used a classic cytological smear taken on the slide, rated in accordance with TBS classification, colposcopy implemented in accordance with the guidelines of the International Federation of Cervical Pathology and Colposcopy from 2003, molecular diagnostic tests based on identifying DNA, mRNA HPV HR and immunocytochemistry diagnostic test--CINtecPLUS.
  
  
  RESULTS
  The sensitivity of Pap test identification of CIN 2+ was of 85% and specificity of 23%. Indicators PPV and NPV were respectively 39% and 72%. The accuracy of cytology reached a level of 46%. DNA HPV HR test obtained 91% sensitivity and 33% specificity of the diagnosis of CIN 2+. Its accuracy was 54%. The value of PPV and NPV for molecular diagnostics was respectively 43% and 87%. For mRNA HPV HR test sensitivity of the method was 79%, the specificity was 67%. CINTecPLUS test achieved 100% sensitivity and 67% specificity in the diagnosis of CIN 2+.
  
  
  CONCLUSIONS
  1. Conventional cytodiagnostics are inferior in terms of both sensitivity and specificity of molecular test for DNA, mRNA HPV HR and immunocytochemical test for detecting of LG SIL and HG SIL. 2. Immunocytochemical technique shows maximum sensitivity and high specificity of detection of actual precancerous stages--CIN 2+.
authors.affiliation: Department of Gynecology and Obstetrics Hospital, NZOZ of St. Alexandra, Kielce, Poland. rokita@kielce.com.pl
authors.forename: Wojciech
authors.initials: W
authors.lastname: Rokita
authors.forename: Witold
authors.initials: W
authors.lastname: Kedzia
authors.forename: Dominik
authors.initials: D
authors.lastname: Pruski
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Friebe
authors.forename: Ewa
authors.initials: E
authors.lastname: Nowak-Markwitz
authors.forename: Robert
authors.initials: R
authors.lastname: Spaczyński
authors.forename: Agata
authors.initials: A
authors.lastname: Karowicz-Bilińska
authors.forename: Marek
authors.initials: M
authors.lastname: Spaczyński
mesh_terms: D002584:Cervix Uteri / Q000378:metabolism / Q000473:pathology / Q000821:virology; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis; D003581:Cytodiagnosis; D004279:DNA, Viral / Q000032:analysis; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D061809:Human Papillomavirus DNA Tests / Q000379:methods*; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D065006:Papanicolaou Test; D011230:Precancerous Conditions / Q000378:metabolism / Q000473:pathology* / Q000821:virology*; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000821:virology*; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000378:metabolism / Q000473:pathology* / Q000821:virology*
chemical_list: D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral; D019394:Ki-67 Antigen