Reflex human papillomavirus deoxyribonucleic acid testing in women with abnormal Papanicolaou smears - 09/09/11
Abstract |
OBJECTIVE: The study examined interrelationships between sensitivity and specificity of “reflex human papillomavirus deoxyribonucleic acid testing” from liquid-based cervical cytologic specimens by means of receiver operator characteristics curves. STUDY DESIGN: A cohort study was performed on 265 women evaluated by colposcopy because of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion found on Papanicolaou smear. RESULTS: At a positive threshold of 0.2 pg/ml (1000 copies of human papillomavirus per test), human papillomavirus deoxyribonucleic acid testing detected 86% of women with cervical intraepithelial neoplasia and 93% of women with high-grade cervical intraepithelial neoplasia with a specificity of 30%. Decreasing the sensitivity of the human papillomavirus test to 1 pg/ml (5000 copies of human papillomavirus per test) improved the specificity of a positive result to 44% but decreased the clinical sensitivity to 78% for cervical intraepithelial neoplasia grade 2 or 3. Relationships between sensitivity and specificity were influenced by patient age and referral diagnosis. For example, limiting the analysis to only women with a referral for atypical squamous cells of undetermined significance found on Papanicolaou smear and a positive human papillomavirus test threshold of 0.5 pg/ml produced a sensitivity of 90% for cervical intraepithelial neoplasia grade 2 or 3 and a test specificity of 55%. CONCLUSION: Human papillomavirus deoxyribonucleic acid testing of residual cellular material from liquid cytologic specimens appears to be more appropriate for older women (>30 years old) and women with atypical squamous cells of undetermined significance, as opposed to low-grade squamous intraepithelial lesion, on their Papanicolaou smears. (Am J Obstet Gynecol 1998;178:962-6.)
Le texte complet de cet article est disponible en PDF.Keywords : Cervical intraepithelial neoplasia, cytology, human papillomavirus
Plan
 | From the Departments of Pathology and Obstetrics and Gynecology, College of Physicians and Surgeons of Columbia University,a Digene Corporation,b the Department of Family Medicine, Medical College of Georgia,c the Department of Pathology, Jewish General Hospital, McGill University,d and Planned Parenthood of Westchester.e |
| Human papillomavirus deoxyribonucleic acid testing kits and supplies provided by Digene Corporation, Silver Spring, Maryland. ThinPrep collection kits supplied by Cytyc Corporation, Boxborough, Massachusetts. |
 | Reprint requests: Thomas C. Wright, Jr., MD, Department of Pathology, Room 16-428 P&S, College of Physicians and Surgeons of Columbia University, 630 W. 168th St., New York, NY 10032. |
| 6/1/87196 |
Vol 178 - N° 5
P. 962-966 - mai 1998 Retour au numéro
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