The viral load of high-risk HPV types was significantly associated with the diagnosis of CIN2 or CIN3 in women referred because of atypical squamous cells and LSIL abnormalities in their cervical smear.
initial cervical cytology showed sensitivity and specificity of 57% and 82% for diagnosis of CIN grades 2 and 3, with a PLR of 3.2 (95% CI: 1.5-6.8). Referral cervical cytology showed a sensitivity and specificity for CIN 2 and 3 of 79% and 84%, respectively, with a PLR of 5.0 (95% CI: 2.5-10.0). Sensitivity (86%), specificity (80%), and PLR (4.3) were similar when a second observer (using a routine technique) reviewed the slide. Using rapid revision by a third observer, the sensitivity was significantly lower (64%). Hybrid capture II showed a high sensitivity (100%), low specificity (43%), and low PLR (1.7, 95% CI: 1.4-2.2).
Because cytological abnormalities correlated generally better with the persistence of biopsy-confirmed CIN1 in this follow-up protocol, HCII test is the second-hand option to Pap test, but the use of both Pap and HCII together seems an unnecessary waste of resources.
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