Usefulness of human papilloma virus testing in the screening of cervical cancer precursor lesions: a retrospective study in 314 cases

Objective: To assess the usefulness of human papilloma virus (HPV) typing f or predicting pre-malignant and malignant cervical lesions. Study design: 3 14 women, who underwent colposcopy, biopsies and high and low-risk HPV typi ng after a confirmed abnormal routine Pap test were studied. HPV-DNAs were typed by using PCR technique. Results: We found a significant increasing ra te of high-risk-HPV by the increasing severity of histology. ranging from 4 0% in negative cases to 86.9% in those with CIN3 lesions. The positive pred ictive Value of high-risk-HPV ranged from 13.3% in patients with atypical s quamous cells of undetermined significance (ASCUS) to 29.4% in those with H SIL. By contrast, negative predictive value was 96% in patients with ASCUS, 97.2% in low-grade squamous intraepithelial lesions (LSIL), and 71.4% in h igh-grade squamous intraepithelial lesions (HSIL). Sensitivity and specific ity for detecting CIN2 or CIN3 was 86.0% and 41.3%, respectively. Conclusio ns: The high negative predictive value of high-risk HPV testing suggests th at HPV negativity could be used Tot predicting the absence of important cer vical lesions, and therefore avoiding unnecessary colposcopy in ASCUS and L SIL cases. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.