European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Quantitative detection of oncogenic HPV DNA using hybrid capture to triage borderline and mildly dyskaryotic Papanicolaou smears
Objective: To investigate the use of hybrid capture to triage borderline and mildly abnormal PAP smears to either colposcopy or continued cytological surveillance. Method: A prospective cross-sectional study of 207 women with either mild or borderline dyskaryosis referred to the colposcopy clinic at the Whittington Hospital, London was done. Quantitative detection of oncogenic human papillomavirus deoxyribose nucleic acid was performed using the solution hybridization technique Hybrid Capture I (Digene Diagnostics). Positive or negative hybrid capture results were compared to colposcopically directed punch biopsy or loop excision of the transformation zone. Results: Hybrid capture correctly predicted 1/1 micro-invasive cancers, 23/24 CIN 3 and 20/24 CIN 2, giving a sensitivity to detect significant disease of CIN 2 or above of 90%. For CIN I, 37 /66 were HPV positive making the sensitivity to detect all grades of CIN 70%. Of women with a normal cervix, 39/92 were HPV positive and in total 58% of the women were HPV positive and would have been referred to colposcopy. Conclusions: Hybrid capture was a simple solution hybridization method which provided a sensitive method of detecting CIN 2 and above lesions in women with minor PAP smear abnormalities. However, the sensitivity for CIN 1 and the specificity were low, meaning that further improvements in the technique are needed before it can be used as a triage strategy.