Polymerase Chain Reaction Human Papillomavirus (HPV) Detection and HPV Genotyping in Invasive Cervical Cancers With Prior Negative HC2 Test Results.
OBJECTIVE
Recently, three large Chinese cohort studies showed that 7.5% to 15.5% of patients with cervical carcinoma had negative high-risk human papillomavirus (hrHPV) test results on prior cytology specimens. These studies raise the question as to whether these negative hrHPV results represent truly hrHPV-negative carcinomas or false-negative hrHPV test results due to limitations in the testing of cytology specimens. This is increasingly an important question with increasing push to use hrHPV testing alone to screen for cervical cancer.


METHODS
We investigated the hrHPV status on the surgical specimens from these same patients with cervical carcinoma using three polymerase chain reaction methods and a linear assay genotyping method.


RESULTS
A variety of HPV genotypes were detected in 28 (45.9%) of 61 cases, all belonging to carcinogenic or possibly carcinogenic categories. HPV 16 was the most common genotype detected in positive cases (66.7%). HPV was detected in 25 (50%) of 50 squamous cell carcinomas and two (66.7%) of three adenosquamous carcinomas and only one (12.5%) of eight endocervical adenocarcinomas.


CONCLUSIONS
Our findings demonstrate that negative hrHPV testing on cervicovaginal cytology specimens in women later diagnosed with cervical carcinoma can be explained by the occurrence of truly HPV-negative carcinomas in more than half of patients. These results should be considered in the development of future cervical cancer screening guidelines.
Obstetrics and Gynecology, Hospital of Fudan University, Shanghai, China.
Xiang
X
Tao
Guangzhou Kingmed Diagnostics, Guangzhou, Guangdong, China.
Baowen
B
Zheng
Qingdao University Medical College, Qingdao, Shandong, China.
Fufen
F
Yin
Guangzhou Kingmed Diagnostics, Guangzhou, Guangdong, China.
Zhengyu
Z
Zeng
Ohio State University Wexner Medical Center, Columbus.
Zaibo
Z
Li
Emory University, Atlanta, GA.
Christopher C
CC
Griffith
Qingdao University Medical College, Qingdao, Shandong, China.
Bing
B
Luo
Guangzhou Kingmed Diagnostics, Guangzhou, Guangdong, China.
Xiangdong
X
Ding
Obstetrics and Gynecology, Hospital of Fudan University, Shanghai, China.
Xianrong
X
Zhou
Magee-Womens Hospital of University of Pittsburgh, Medical Center, Pittsburgh, PA.
Chengquan
C
Zhao
D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D055088:Early Detection of Cancer / Q000379:methods; D005188:False Negative Reactions; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis*; D016133:Polymerase Chain Reaction / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000235:genetics*; D014626:Vaginal Smears
D004279:DNA, Viral
Cervical cancer; HPV PCR testing; HPV genotyping; HPV-negative cervical cancer; Human papillomavirus