Usefulness of DNA ploidy measurement on liquid-based smears showing conflicting results between cytology and high-risk human papillomavirus typing.
Fiche publication
Date publication
novembre 2002
Journal
American journal of clinical pathology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr CLAVEL Christine
Tous les auteurs :
Lorenzato M, Bory JP, Cucherousset J, Nou JM, Bouttens D, Thil C, Dez F, Evrard G, Quereux C, Birembaut P, Clavel C
Lien Pubmed
Résumé
To improve the positive predictive value (PPV) for high-risk human papillomavirus (HR-HPV) in primary screening, DNA ploidy was measured on the same liquid-based sample by image cytometry in 984 cases showing discrepancies between cytology and HR-HPV testing. Of the conflicting results, 14.5% corresponded to a cytologic lesion (from atypical squamous cells of undetermined significance to high-grade squamous intraepithelial lesion [HSIL]) without HPV detected, and 85.5% of smears were within normal limits but revealed an HR-HPV infection. A suspect DNA profile was associated significantly with a lesion. In 497 patients who underwent repeated HPV testing, a normal DNA profile at the first smear predicted the clearance of HPV infection (sensitivity, 81.5%; specificity, 45.4%; PPV, 69%; negative predictive value, 62.4%). In persistent HR-HPV infection, a suspect DNA profile at the first smear increased the PPVfrom 10.8% to 22.7% for the detection of a histologically proven HSIL with a sensitivity of 95.2%. DNA ploidy can be used to select smears with high risk of HSIL, especially in cases of persistent HR-HPV infection.
Mots clés
Adolescent, Adult, Aged, Aged, 80 and over, Cervical Intraepithelial Neoplasia, diagnosis, DNA, Neoplasm, analysis, DNA, Viral, analysis, Female, Humans, Image Cytometry, Middle Aged, Papillomaviridae, classification, Papillomavirus Infections, complications, Ploidies, Predictive Value of Tests, Tumor Virus Infections, complications, Uterine Cervical Neoplasms, diagnosis, Vaginal Smears, methods
Référence
Am. J. Clin. Pathol.. 2002 Nov;118(5):708-13