The Usefulness of Concomitant High-Risk Human Papillomavirus Test and Colposcopy in Combination with the Papanicolaou Test in ASCUS Patients

Kim, Min Kyung; Sohn, Jin Hee; Kim, Chul Hwan; Choi, Jong Sang

Abstract

The objective of this study was to ascertain whether or not the high-risk human papillomavirus(HPV) test, when coupled with Papanicolaou(Pap) smears, would prove useful in the screening and management of patients in whom abnormal Pap smear results had been obtained. Concomitant high-risk HPV detection using the hybrid capture II test and colposcopy with a Pap smear were performed with 176 patients, all of whom had been screened for both cervical carcinoma and precancerous lesions. We concomitantly performed colposcopies on these patients. Upon the follow-ups, the histologic diagnoses of these patients were confirmed via either biopsy or hysterectomy. The rate of high-risk HPV detection was correlated with cytologic diagnoses and colposcopic findings. The group composed of the high-risk HPV-positive ASCUS patients exhibited a 55.7% rate of cervical intraepithelial neoplasia(CIN), a significantly higher rate than the 7.5% result obtained in the high-risk HPV- negative ASCUS group. HPV test showed high sensitivity(87%) and low specificity (62.6%) in detection of CIN and colposcopy also showed high sensitivity (88%) and low specificity(22%). Any combination of these tests improve sensitivity, but not specificity. High-risk HPV tests, when coupled with Pap smears, constituted a useful triage approach with regard to colposcopy-directed biopsies in patients in whom a cytologic diagnosis of ASCUS had been rendered.