Prediction of recurrent and residual cervical dysplasia by human papillomavirus detection among patients with abnormal cytology

To determine the discriminative capacity of human papillomavirus (HPV) DNA testing for recurrent and residual cervical dysplasia, 43 patients with abn ormal cytology after treatment for cervical dysplasia were tested for the p resence of HPV DNA by PCR. An endocervical curettage was performed in all p atients for histological examination, Sixteen of the 43 patients showed mod erate or severe dysplasia. The HPV test was positive in all 16 patients wit h recurrent or residual dysplasia and negative in 12 of the 27 patients wit hout dysplasia. The sensitivity and specificity of the HPV test were 100 an d 44%, respectively. The likelihood ratio of a positive HPV test was 1.8, w hereas a negative HPV test had a likelihood ratio of 0.12. Testing for the presence of HPV has the potential to select patients without recurrent or r esidual cervical dysplasia who have an abnormal cytological smear. This may have clinical implications, since unnecessary diagnostic conizations may b e avoided in patients with abnormal cytology after treatment for cervical d ysplasia and a negative HPV test. (C) 1999 Academic Press.