DNA image cytometry and human papillomavirus (HPV) detection help to select smears at high risk of high-grade cervical lesions

• Published in: The Journal of pathology Vol. 194; no. 2; pp. 171 - 176
• Main Authors: Lorenzato, Marianne, Clavel, Christine, Masure, Marie, Nou, Jean-Marie, Bouttens, Dominique, Evrard, Ghislaine, Bory, Jean-Paul, Maugard, Brigitte, Quereux, Christian, Birembaut, Philippe
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.06.2001; Wiley
• Subjects: Biological and medical sciences; cervical lesions; Cervix Uteri - pathology; Cervix Uteri - virology; Chi-Square Distribution; cytological screening; Cytological Techniques; DNA; DNA - genetics; DNA image cytometry; Female; Follow-Up Studies; Genital system. Mammary gland; Human papillomavirus; Humans; Image Cytometry; In Situ Hybridization; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Papillomaviridae - isolation & purification; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Ploidies; Predictive Value of Tests; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Human; High risk; Premalignant lesion; Prognosis; Cervical smear; Papovaviridae; Medical screening; Female genital diseases; Papillomavirus; Virus; Pathology; Cytometry; Human papillomavirus; Cervical dysplasia; DNA; Cytopathology; Female; Diagnosis; Technique; Molecular biology; Uterine cervix diseases; High malignancy
• ISSN: 0022-3417; 1096-9896
• DOI: 10.1002/path.874

Three samples were submitted from women undergoing routine screening (n=910): two smears (one for routine cytology and one for DNA image cytometry) and a scrape for human papillomavirus (HPV) testing. DNA histograms were classified as suspect in cases of aneuploidy, polyploidy, and/or diploidy with a high proliferation rate. Follow‐up was available in 239 cases. The primary end‐point was the presence of a high‐grade squamous intraepithelial lesion (HGSIL) at biopsy. Seventy women (7.7%) had a high‐risk (HR) HPV infection and a suspect DNA profile. In 77 women with cytological abnormalities, 28 HGSILs were detected: four with a prior diagnosis of ASCUS (all HR‐HPV infected including three with a suspect DNA profile), three with smears evocative of LGSIL (all with HR‐HPV infection and a suspect DNA profile), and 21 with smears evocative of HGSIL (all with HR‐HPV infection and 20 with a suspect DNA profile). During the follow‐up period, out of 239 women with a cytologically normal smear at first entry, five developed a HGSIL; all were HR‐HPV‐positive and four had a suspect DNA profile at the first smear. HR‐HPV detection alone gives a sensitivity of 100% for the detection of HGSIL, with a specificity of 84.3%, whereas DNA measurement associated with HPV testing significantly enhances the specificity to 95.4%. Thus, the combination of HPV testing and DNA measurement provides a highly sensitive and specific evaluation of the risk of HGSIL on cervical smears. Copyright © 2001 John Wiley & Sons, Ltd.