Human papillomavirus testing by hybrid capture appears to be useful in triaging women with a cytologic diagnosis of atypical squamous cells of undetermined significance

J. Thomas Cox, Attila T. Lorincz, Mark H. Schiffman, Mark E. Sherman, Allison Cullen, Robert J Kurman

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Our purpose was to determine the clinical value of human papillomavirus deoxyribonucleic acid testing with the hybrid capture test, specifically to examine whether human papillomavirus testing could identify which women with Papanicolaou smears read as atypical squamous cells of undetermined significance were most likely to have histologically confirmed cervical intraepithelial neoplasia. STUDY DESIGN: Hybrid capture testing for 14 human papillomavirus types, repeat Papanicolaou smears, and colposcopically directed biopsies were performed concurrently on 217 women referred to a student health colposcopy clinic with a previous Papanicolaou smear read as atypical squamous cells of undetermined significance. RESULTS: Human papillomavirus deoxyribonucleic acid positivity was associated with an eightfold increased likelihood of histologic confirmation of cervical intraepithelial neoplasia. The sensitivity of hybrid capture for any cervical intraepithelial neoplasia was 86% ( 43 50) and for grade 2 or 3 was 93% ( 14 15), whereas the corresponding values for the repeat Papanicolaou smear were 60% ( 30 50) and 73% ( 11 15), respectively. Moreover, high viral levels of human papillomavirus types known to be associated with cervical cancer were strongly predictive of high-grade cervical intraepithelial neoplasia. CONCLUSIONS: Testing for human papillomavirus deoxyribonucleic acid with hybrid capture appears to offer an effective means by which patients whose cervical Papanicolaou smears have been read as atypical squamous cells of undetermined significance could be triaged for colposcopy. In particular, sensitivity for high-grade cervical intraopithelial neoplasia could be maintained and specificity markedly improved by referring only those patients who had elevated levels of human papillomavirus deoxyribonucleic acid of cancer-associated viral types.

Original languageEnglish (US)
Pages (from-to)946-954
Number of pages9
JournalAmerican Journal of Obstetrics and Gynecology
Volume172
Issue number3
DOIs
StatePublished - 1995
Externally publishedYes

Fingerprint

Papanicolaou Test
Cervical Intraepithelial Neoplasia
Colposcopy
DNA
Vaginal Smears
Atypical Squamous Cells of the Cervix
Uterine Cervical Neoplasms
Neoplasms
Students
Biopsy
Health

Keywords

  • Atypical squamous cells of undetermined significance
  • human papillomavirus deoxyribonucleic acid testing
  • hybrid capture

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Human papillomavirus testing by hybrid capture appears to be useful in triaging women with a cytologic diagnosis of atypical squamous cells of undetermined significance. / Cox, J. Thomas; Lorincz, Attila T.; Schiffman, Mark H.; Sherman, Mark E.; Cullen, Allison; Kurman, Robert J.

In: American Journal of Obstetrics and Gynecology, Vol. 172, No. 3, 1995, p. 946-954.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: Our purpose was to determine the clinical value of human papillomavirus deoxyribonucleic acid testing with the hybrid capture test, specifically to examine whether human papillomavirus testing could identify which women with Papanicolaou smears read as atypical squamous cells of undetermined significance were most likely to have histologically confirmed cervical intraepithelial neoplasia. STUDY DESIGN: Hybrid capture testing for 14 human papillomavirus types, repeat Papanicolaou smears, and colposcopically directed biopsies were performed concurrently on 217 women referred to a student health colposcopy clinic with a previous Papanicolaou smear read as atypical squamous cells of undetermined significance. RESULTS: Human papillomavirus deoxyribonucleic acid positivity was associated with an eightfold increased likelihood of histologic confirmation of cervical intraepithelial neoplasia. The sensitivity of hybrid capture for any cervical intraepithelial neoplasia was 86{\%} ( 43 50) and for grade 2 or 3 was 93{\%} ( 14 15), whereas the corresponding values for the repeat Papanicolaou smear were 60{\%} ( 30 50) and 73{\%} ( 11 15), respectively. Moreover, high viral levels of human papillomavirus types known to be associated with cervical cancer were strongly predictive of high-grade cervical intraepithelial neoplasia. CONCLUSIONS: Testing for human papillomavirus deoxyribonucleic acid with hybrid capture appears to offer an effective means by which patients whose cervical Papanicolaou smears have been read as atypical squamous cells of undetermined significance could be triaged for colposcopy. In particular, sensitivity for high-grade cervical intraopithelial neoplasia could be maintained and specificity markedly improved by referring only those patients who had elevated levels of human papillomavirus deoxyribonucleic acid of cancer-associated viral types.",
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