Molecular detection of human papillomavirus in women with minor-grade cervical cytology abnormalities

Background: Human papillomavirus (HPV) has been shown to be the major risk factor for the development of cervical carcinoma, the second most common ca ncer among women worldwide. Cervical cytology has been the main screening t ool for detection of premalignant lesions in last 50 years. Objective: The utility of a molecular assay for detection of HPV in cervical smears was ev aluated. Study design: A total of 466 women with minor-grade cervical cytol ogy abnormality supposed to be produced by HPV were included. Patients were classified into three groups: Patients with reactive changes, patients wit h cervical intraepithelial neoplasia grade 1 (CIN 1), and patients with cer vical intraepithelial neoplasia grade 2 (CIN 2). In all patients, another c ervical swab was obtained and tested for the HPV genome using the Digene Hy brid Capture II. This assay is able to distinguish between high-risk and lo w-risk HPV types. Results: Based on cytology results, 44 patients showed re active changes? 250 patients displayed CIN 1, and 172 patients displayed CI N 2, With the molecular assay, HPV was detected in 289/466 (62%) patients. The high-risk HPV type was present in 263 (56.4%) patients and the low-risk type in 26 (5,5%) patients. In 25% of patients with reactive changes, the HPV genome was detected. Corresponding rates for patients with CIN 1 and CI N 2 were 55 and 81%, respectively. Conclusion: Molecular detection of HPV s hould additionally be used to cytology in patients whose cervical smears di splay reactive changes, CIN 1, or CIN 2. The employed assay allows identifi cation of patients who are at risk for development of high-grade cervical l esions. (C) 2001 Elsevier Science B.V, All rights reserved.