DNA image cytometry and human papillomavirus (HPV) detection help to select smears at high risk of high-grade cervical lesions.
Fiche publication
Date publication
juin 2001
Journal
The Journal of pathology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr CLAVEL Christine
Tous les auteurs :
Lorenzato M, Clavel C, Masure M, Nou JM, Bouttens D, Evrard G, Bory JP, Maugard B, Quereux C, Birembaut P
Lien Pubmed
Résumé
Three samples were submitted from women undergoing routine screening (n=910): two smears (one for routine cytology and one for DNA image cytometry) and a scrape for human papillomavirus (HPV) testing. DNA histograms were classified as suspect in cases of aneuploidy, polyploidy, and/or diploidy with a high proliferation rate. Follow-up was available in 239 cases. The primary end-point was the presence of a high-grade squamous intraepithelial lesion (HGSIL) at biopsy. Seventy women (7.7%) had a high-risk (HR) HPV infection and a suspect DNA profile. In 77 women with cytological abnormalities, 28 HGSILs were detected: four with a prior diagnosis of ASCUS (all HR-HPV infected including three with a suspect DNA profile), three with smears evocative of LGSIL (all with HR-HPV infection and a suspect DNA profile), and 21 with smears evocative of HGSIL (all with HR-HPV infection and 20 with a suspect DNA profile). During the follow-up period, out of 239 women with a cytologically normal smear at first entry, five developed a HGSIL; all were HR-HPV-positive and four had a suspect DNA profile at the first smear. HR-HPV detection alone gives a sensitivity of 100% for the detection of HGSIL, with a specificity of 84.3%, whereas DNA measurement associated with HPV testing significantly enhances the specificity to 95.4%. Thus, the combination of HPV testing and DNA measurement provides a highly sensitive and specific evaluation of the risk of HGSIL on cervical smears.
Mots clés
Cervix Uteri, pathology, Chi-Square Distribution, Cytological Techniques, DNA, genetics, Female, Follow-Up Studies, Humans, Image Cytometry, In Situ Hybridization, Papillomaviridae, isolation & purification, Ploidies, Predictive Value of Tests, Uterine Cervical Neoplasms, pathology
Référence
J. Pathol.. 2001 Jun;194(2):171-6