HUMAN-PAPILLOMAVIRUS (HPV) DNA ASSAY AS AN ADJUNCT TO LIQUID-BASED PAP TEST IN THE DIAGNOSTIC TRIAGE OF WOMEN WITH AN ABNORMAL PAP SMEAR

Objective: The diagnostic performance and clinical value of the combin ed use of liquid-based Pap test and human papillomavirus testing were determined in 336 patients with a previous abnormal smear. Method: Sub sequent histologic evaluation was used as definitive diagnosis. Result : The combined use of liquid-based Pap test and HPV DNA testing showed higher rates in sensitivity (99.0%), specificity (59.3%), positive pr edictive value (89.9%) and negative predictive value (94.5%) than eith er cytology alone (sensitivity 98.8%, specificity 45.7%, positive pred ictive value 84.7%, negative predictive value 92.6%) or HPV DNA testin g alone (sensitivity 84.9%, specificity 67.4%, positive predictive val ue 88.8%, negative predictive value 59.5%). Conclusion: The study demo nstrated that the diagnostic accuracy for cervical cancer and its prec ursors was improved by using the liquid-based Pap test as a primary di agnostic procedure and HPV assay as an adjunctive test. This informati on may assist the clinicians in triaging patients with equivocal cytol ogic cervical atypias. (C) 1998 International Federation of Gynecology and Obstetrics.