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Hybrid Capture II Testing for High-Risk Human Papillomavirus DNA in the Follow-up of Women Treated for High-Grade Cervical Intraepithelial Neoplasia

Tan, Jeffrey H.J. MBBS, FRANZCOG1,2; Garland, Suzanne M. MBBS, FRCPA, FAChSHM, FANZCOG Ad Eundem1,3,4; Tabrizi, Sepehr N. PhD1,3,4; Moore, Elya E. MS, PhD3,4; Danielewski, Jennifer A. PhD3,4; Quinn, Michael A. MBChB, MGO, MRCP(UK), FRCOG, FRANZOG, CGO1,2

Journal of Lower Genital Tract Disease: July 2013 - Volume 17 - Issue 3 - p 308–314
doi: 10.1097/LGT.0b013e31826cd7c1
Original Articles

Objective: This study aimed to estimate and compare the validity of high-risk human papillomavirus DNA (HR-HPV DNA) testing using Hybrid Capture II with and without Pap cytological examination in the detection of incident high-grade cervical intraepithelial neoplasia (CIN 2+) after treatment.

Materials and Methods: A total of 1,608 women undergoing ablative or excisional treatment were recruited to the study between May 2001 and June 2005, of whom 985 women were treated for CIN 2+. High-risk HPV DNA tests and Pap smears were performed once in every 6 months for 24 months after treatment.

Results: A total of 888 women were eligible for analysis. High-grade cervical intraepithelial neoplasia was detected in 22 women (2.5%) for the 24 months after treatment. The sensitivity for CIN 2+ detection with cytological diagnosis ranged from 43% to 100%, from 67% to 100% for HR-HPV DNA test, and from 67% to 100% for both tests combined. The specificity of cytological diagnosis ranged from 94% to 97%, from 75% to 84% for HR-HPV DNA test, and from 80% to 82% for both tests combined. The positive predictive value for cytological diagnosis ranged from 8% to 30%, from 4% to 14% for HR-HPV DNA test, and from 4% to 11% for both tests combined. The negative predictive value was 99% or greater for cytological diagnosis alone, HR-HPV DNA test alone, or for both tests combined.

Conclusions: As histologically proven CIN 2+ after treatment for this group of women was low, adding HR-HPV DNA testing to Pap smear did not increase the detection of CIN 2+ or enhance the negative predictive value of cytological diagnosis alone.

The addition of HR-HPV DNA testing to Pap smear did not increase the detection of CIN 2+ or enhance the negative predictive value of cytological diagnosis alone.

1Department of Obstetrics and Gynaecology, University of Melbourne; 2Oncology and Dysplasia Unit, and 3Department of Microbiology and Infectious Diseases, Royal Women’s Hospital; and 4Murdoch Children’s Research Institute, Melbourne, Australia

Reprint requests to: Jeffrey H.J. Tan, MBBS, FRANZCOG, Suite 10, Level 2, Royal Women’s Hospital, Parkville, Victoria, Australia 3052. E-mail: jeff.tan@thewomens.org.au

No funding was received for this research and publication.

Copyright © 2013 by the American Society for Colposcopy and Cervical Pathology