Triage of atypical squamous cells of undetermined significance with hybrid capture II: Colposcopy and histologic human papillomavirus correlation

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 101; no. 3; pp. 481 - 489
• Main Authors: Lonky, Neal M, Felix, Juan C, Naidu, Yathi M, Wolde-Tsadik, Girma
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2003; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - virology; Cervical Intraepithelial Neoplasia - pathology; Cervical Intraepithelial Neoplasia - virology; Colposcopy; DNA, Viral - genetics; Female; Female genital diseases; Genital system. Mammary gland; Gynecology. Andrology. Obstetrics; Humans; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Papanicolaou Test; Papillomaviridae - genetics; Papillomaviridae - isolation & purification; Papillomavirus Infections - pathology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Polymerase Chain Reaction; Predictive Value of Tests; Triage; Tumor Virus Infections - pathology; Tumors; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Vaginal Smears - methods; Vaginal Smears - standards; Performance evaluation; Human; Colposcopy; Stage classification; Papovaviridae; Uterine cervix; Malignant tumor; Female genital diseases; Infection; Papillomavirus; Virus; Polymerase chain reaction; Human papillomavirus; Viral disease; Female; Papanicolaou smear test; Diagnosis; Uterine cervix diseases
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1016/S0029-7844(02)02715-1

To estimate the effectiveness of Hybrid Capture II to predict high-grade cervical intraepithelial neoplasia (CIN) from a cytological cervical sample. Evidence of high-risk human papillomavirus (HPV) was also determined from biopsy samples using the polymerase chain reaction (PCR) for women referred with atypical squamous cells of undetermined significance (ASCUS) Papanicolaou smears.
We screened 8170 women with Papanicolaou smears, of whom 278 (3.4%) returned ASCUS. All ASCUS cases underwent colposcopy and Hybrid Capture II testing. High-grade CIN biopsy specimens were tested for high-risk HPV by PCR.
Nearly 30% of ASCUS cases had CIN biopsy results (11.9% showing CIN II or CIN III and 17.6% showing CIN I). Hybrid Capture II positive rates were 93.3% for cases with CIN III, 72.2% for CIN II, and 51.0% for CIN I (
P < .001). ASCUS-Premalignant Process Favored cases showed a 28.1% high-grade biopsy rate and a 100% Hybrid Capture II positive rate. For ASCUS-Undefined and ASCUS-Reactive Process Favored cases, Hybrid Capture II returned positive in 90.9% of CIN III and 61.5% of CIN II cases (
P < .001). Sixty-nine of 178 (38.8%) patients with no evidence of CIN tested positive for Hybrid Capture II. Human papillomavirus deoxyribonucleic acid (DNA) high-risk subtypes were detected by PCR in the tissue of all high-grade CIN cases with negative Hybrid Capture II results.
Hybrid Capture II returned negative in 25% of cases with biopsy-proven high-grade CIN with associated high-risk HPV DNA by PCR (non-Premalignant ASCUS subset), and positive in 39.3% of cases with normal results; this limits its clinical utility.