Quantitative detection of oncogenic HPV DNA using hybrid capture to triageborderline and mildly dyskaryotic Papanicolaou smears

Objective: To investigate the use of hybrid capture to triage borderline an d mildly abnormal PAP smears to either colposcopy or continued cytological surveillance. Method: A prospective cross-sectional study of 207 women with either mild o r borderline dyskaryosis referred to the colposcopy clinic at the Whittingt on Hospital, London was done. Quantitative detection of oncogenic human pap illomavirus deoxyribose nucleic acid was performed using the solution hybri dization technique Hybrid Capture I (Digene Diagnostics). Positive or negat ive hybrid capture results were compared to colposcopically directed punch biopsy or loop excision of the transformation zone. Results: Hybrid capture correctly predicted 1/1 micro-invasive cancers, 23/ 24 CIN 3 and 20/24 CIN 2, giving a sensitivity to detect all grades of CIN 70%. Of women with a normal cervix, 39/92 were HPV positive and in total 58 % of the women were HPV positive and would have been referred to colposcopy . Conclusions: Hybrid capture was a simple solution hybridization method whic h provided a sensitive method of detecting CIN 2 and above lesions in women with minor PAP smear abnormalities. However, the sensitivity for CIN 1 and the specificity were low, meaning that further improvements in the techniq ue are needed before it can be used as a triage strategy.