Detection of human papillomavirus deoxyribonucleic acid in exfoliated cervicovaginal cells as a predictor of cervical neoplasia in a high-risk population

Diane B. Ritter, Anna S. Kadish, Sten H. Vermund, Seymour L. Romney, Daniela Villari, Robert D. Burk

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Specific types of human papillomavirus are currently implicated as etiologic agents of precancerous and cancerous lesions of the cervix. We have previously described the use of cervicovaginal lavage and molecular hybridization to detect human papillomavirus infections of the cervix. We report here the predictive value of this method of human papillomavirus detection to identify women with biopsy proved dysplastic and cancerous lesions of the cervix. One hundred ninety-one women from a city hospital colposcopy clinic underwent concurrent Papanicolaou smear, cervicovaginal lavage, and coloposcopically directed cervical biopsy. Human papillomavirus deoxyribonucleic acid was detected in 114 (59.7%) of these women. Of the positive results, human papillomavirus type 16 accounted for 23.7%, human papillomavirus type 18 for 10.5%, human papillomavirus type six or 11 for 6.2%, related human papillomavirus types for 52.6%, and 7.0% contained more than one type. The distribution of human papillomavirus types was similar in both women younger than 40 years of age and in older women. Eighty-nine of 128 (69.5%) women <40 years old with cervical lesions had positive findings of human papillomavirus, and 18 of 29 (62.1 %) older women with cervical lesions had positive findings of human papillomavirus. Detection of human papillomavirus types 16 and 18 identified only 35 of 157 (22.3%) women with cervical lesions. The sensitivity of detecting all types of human papillomavirus as a predictor of a biopsy proved lesion (68.0%) was comparable with the sensitivity of cytologic examination alone (74.0%). However, human papillomavirus detection combined with the Papanicolaou smear provided an increased overall sensitivity of 89.3% (p < 0.01). In fact, women either positive for human papillomavirus or having abnormal cytologic findings were 11.8 times more likely to have a biopsy proved cervical lesion than human papillomavirus-negative women with negative cytologic results (95% confidence interval for odds ratio: 5.3 to 26.6). We conclude that the sensitivity of cytologic examination plus human papillomavirus detection is superior to the use of either cytologic studies or human papillomavirus detection alone in identifying patients with cervical lesions.

Original languageEnglish (US)
Pages (from-to)1517-1525
Number of pages9
JournalAmerican Journal of Obstetrics and Gynecology
Volume159
Issue number6
DOIs
StatePublished - 1988

Fingerprint

DNA
Population
Neoplasms
Human papillomavirus 18
Cervix Uteri
Biopsy
Papanicolaou Test
Human papillomavirus 16
Therapeutic Irrigation
Colposcopy
Papillomavirus Infections
Urban Hospitals
Odds Ratio
Confidence Intervals

Keywords

  • cervical cancer screening
  • cervical intraepithelial neoplasia
  • cervix cancer
  • Human papillomavirus
  • Papanicolaou smear

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Detection of human papillomavirus deoxyribonucleic acid in exfoliated cervicovaginal cells as a predictor of cervical neoplasia in a high-risk population. / Ritter, Diane B.; Kadish, Anna S.; Vermund, Sten H.; Romney, Seymour L.; Villari, Daniela; Burk, Robert D.

In: American Journal of Obstetrics and Gynecology, Vol. 159, No. 6, 1988, p. 1517-1525.

Research output: Contribution to journalArticle

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abstract = "Specific types of human papillomavirus are currently implicated as etiologic agents of precancerous and cancerous lesions of the cervix. We have previously described the use of cervicovaginal lavage and molecular hybridization to detect human papillomavirus infections of the cervix. We report here the predictive value of this method of human papillomavirus detection to identify women with biopsy proved dysplastic and cancerous lesions of the cervix. One hundred ninety-one women from a city hospital colposcopy clinic underwent concurrent Papanicolaou smear, cervicovaginal lavage, and coloposcopically directed cervical biopsy. Human papillomavirus deoxyribonucleic acid was detected in 114 (59.7{\%}) of these women. Of the positive results, human papillomavirus type 16 accounted for 23.7{\%}, human papillomavirus type 18 for 10.5{\%}, human papillomavirus type six or 11 for 6.2{\%}, related human papillomavirus types for 52.6{\%}, and 7.0{\%} contained more than one type. The distribution of human papillomavirus types was similar in both women younger than 40 years of age and in older women. Eighty-nine of 128 (69.5{\%}) women <40 years old with cervical lesions had positive findings of human papillomavirus, and 18 of 29 (62.1 {\%}) older women with cervical lesions had positive findings of human papillomavirus. Detection of human papillomavirus types 16 and 18 identified only 35 of 157 (22.3{\%}) women with cervical lesions. The sensitivity of detecting all types of human papillomavirus as a predictor of a biopsy proved lesion (68.0{\%}) was comparable with the sensitivity of cytologic examination alone (74.0{\%}). However, human papillomavirus detection combined with the Papanicolaou smear provided an increased overall sensitivity of 89.3{\%} (p < 0.01). In fact, women either positive for human papillomavirus or having abnormal cytologic findings were 11.8 times more likely to have a biopsy proved cervical lesion than human papillomavirus-negative women with negative cytologic results (95{\%} confidence interval for odds ratio: 5.3 to 26.6). We conclude that the sensitivity of cytologic examination plus human papillomavirus detection is superior to the use of either cytologic studies or human papillomavirus detection alone in identifying patients with cervical lesions.",
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