DOES TYPING OF HUMAN-PAPILLOMAVIRUS ASSIST IN THE TRIAGE OF WOMEN WITH REPEATED LOW-GRADE, CERVICAL CYTOLOGIC ABNORMALITIES

Objective, To evaluate the ability of testing for high-risk human papi llomavirus (HPV) using the hybrid capture technique to detect cervical intraepithelial neoplasia (CIN) in patients with repeated low-grade c ervical cytologic abnormalities and an adequate and normal colposcopy. Methods. Hybrid capture testing and LEETZ were performed on 166 women with repeated low-grade cervical cytologic abnormalities who were ref erred for colposcopy which was to be adequate and normal. Results. A h ighly significant correlation (P < 0.0001) was found between a positiv e test for high-risk HPV types and the finding of CIN II,III. In 67 wo men with atypical squamous cells of undetermined significance on repea ted cytologic studies, a positive test for high-risk HPV types had a s ensitivity and specificity of 90 and 96.5%, respectively, for detectin g CIN II,III, In 99 patients with low-grade squamous intraepithelial l esions found on repeated cytologic study, a positive test for high-ris k HPV types identified all patients as having CIN II,III on cone biops y (sensitivity, 100%), with a specificity of 86.4%. Restriction of tis sue sampling to women who were positive for high-risk HPV types would have reduced the number of tissue samplings performed to 20.4%, while identifying 20 of 21 patients with biopsy-confirmed CIN II,III. Conclu sion. A positive hybrid capture test for high-risk HPV types is highly sensitive and specific for detecting CIN II,III in patients with repe ated low-grade cervical cytologic abnormalities and an adequate and no rmal colposcopy and may be used in the triage of these women before pe rforming tissue sampling. (C) 1998 Academic Press.