Korean J Gynecol Oncol Colposc.  1997 Mar;8(1):37-46.

Detection of Human Papillomavirus in Conical Scrape Specimens Using Co-nested PCR and Hybrid Capture System


Human papillomavirus(HPV) has implicated in the development of cervical cancer. Several studies have suggested a strong correlation between HPV 16, 18 and cervical intraepithelial neoplasia(CIN). Co-nested polymerase chain reaction(Cn-PCR) technique which is more sensitive 2-step PCR than 1-step PCR was developed to simultaneous detection and typing of HPV by using general and nested general primer pairs localized within the Ll region and general and nested 16, 18 type specific primer pairs localized within the E6ORF This study was performed to determine the validity of the Cn-PCR method for HPV detection and potential clinical uses as screening method for the identification of CIN and compare with Hybrid capture method. Papanicolaou test and Cn-PCR and Hybrid capture test for HPV infection were performed on 298 women visited for cervical cancer screening. Among these cases, 167 cases of persistent atypical squamous cell undetermined significance(ASCUS), cervical erosion and abnormal cytologic result above Low grade squamous intraepithelial lesion(LSIL) were histologically confirmed. Comparing the positive rate of HPV among patients with CIN and cervical cancer, there was a significant positive correlation between the positive rate of HPV type 16, 18 and the degree of histologic malignancy(P<0.01). The sensitivity of HPV type 16, 18 by using Cn-PCR for CIN grade II, III and cancer was 46%, whereas the corresponding value for the Hybrid capture was 77%. But HPV type 16, 18 were more strongly predictive of high grade CIN. The sensitivity and positive predictive value of combination test with cytology and Cn-PCR were 90% and 71%, whereas the corresponding values of same test modality with Hybrid Capture were 93% and 41%. Then some combination of the two modalities will produce better performance than either alone, but there was no significant difference in sensitivity between the combination of Cn-PCR and cytology test and same combination with Hybrid capture and the positive predictive value was higher in combination Cn-PCR and cytology test. From these results, We confirmed that Cn-PCR is sensitive and reliable method for the simultaneous detection and typing of HPV. In particular, HPV testing appears to be helpful in determining which women with mildly abnormal smears have high-grade underlying lesions in need of immediate referral for colposcopy.

MeSH Terms

Human papillomavirus 16
Mass Screening
Papanicolaou Test
Polymerase Chain Reaction*
Referral and Consultation
Uterine Cervical Neoplasms
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