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Abstract
OBJECTIVE: Our purpose was to determine the clinical value of human papillomavirus deoxyribonucleic
acid testing with the hybrid capture test, specifically to examine whether human papillomavirus
testing could identify which women with Papanicolaou smears read as atypical squamous
cells of undetermined significance were most likely to have histologically confirmed
cervical intraepithelial neoplasia.
STUDY DESIGN: Hybrid capture testing for 14 human papillomavirus types, repeat Papanicolaou smears,
and colposcopically directed biopsies were performed concurrently on 217 women referred
to a student health colposcopy clinic with a previous Papanicolaou smear read as atypical
squamous cells of undetermined significance.
RESULTS: Human papillomavirus deoxyribonucleic acid positivity was associated with an eightfold
increased likelihood of histologic confirmation of cervical intraepithelial neoplasia.
The sensitivity of hybrid capture for any cervical intraepithelial neoplasia was 86%
(![Math Eq]()
) and for grade 2 or 3 was 93% (![Math Eq]()
), whereas the corresponding values for the repeat Papanicolaou smear were 60% (![Math Eq]()
) and 73% (![Math Eq]()
), respectively. Moreover, high viral levels of human papillomavirus types known to
be associated with cervical cancer were strongly predictive of high-grade cervical
intraepithelial neoplasia.
) and for grade 2 or 3 was 93% (
), whereas the corresponding values for the repeat Papanicolaou smear were 60% (
) and 73% (
), respectively. Moreover, high viral levels of human papillomavirus types known to
be associated with cervical cancer were strongly predictive of high-grade cervical
intraepithelial neoplasia.CONCLUSIONS: Testing for human papillomavirus deoxyribonucleic acid with hybrid capture appears
to offer an effective means by which patients whose cervical Papanicolaou smears have
been read as atypical squamous cells of undetermined significance could be triaged
for colposcopy. In particular, sensitivity for high-grade cervical intraopithelial
neoplasia could be maintained and specificity markedly improved by referring only
those patients who had elevated levels of human papillomavirus deoxyribonucleic acid
of cancer-associated viral types.
Keywords
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Article Info
Publication History
Accepted:
August 30,
1994
Received in revised form:
August 17,
1994
Received:
May 25,
1994
Footnotes
☆Supported by Digene Diagnostics in the form of materials and masked testing for human papillomavirus deoxyribonucleic acid by hybrid capture and $500.00 for secretarial services for data entry at the University of California.
Identification
Copyright
© 1995 Published by Elsevier Inc.
