High‐risk human papillomavirus DNA testing and high‐grade cervical intraepithelial lesions

Abstract

HPV DNA testing is a useful indicator in the management of patients with ASC-US and plays an important role in the evaluation of risk for CIN 2,3 and cervical cancer.

Triage of ASC‐H: A meta‐analysis of the accuracy of high‐risk HPV testing and other markers to detect cervical precancer

“…The pooled absolute specificity for excluding CIN2 + and CIN3 + was 45% (95% CI, 41%‐50%) and 42% (95% CI, 34%‐51%), respectively (Table and Fig. ) . The corresponding SROC plots for the outcomes of CIN2 + and CIN3+, shown in Figure , display the variation of the test accuracy in the individual studies as well as the overall pooled accuracy.…”

“…An overview of the study design, population, and test characteristics of the included studies is presented in Supporting Table 1 (see online supporting information). Eight reports had a prospective design, and 17 reports had a retrospective design . Eighteen studies included women with ASC‐H identified through primary screening, and 7 studies recruited subjects in colposcopy clinics to which women had been referred because of a prior cytological result of ASC‐H .…”

“…The main evaluated index test was the HC2 test because it is the most widely studied hrHPV assay. HC2 targets DNA sequences of HPV types 16,18,31,33,35,38,39,45,51,52,56,58,59, and 68 with the standard cutoff (signal strength [relative light units 1] expressing semiquantitatively the viral load in comparison with a control sample with 1 pg of HPV DNA/mL). Other tests, including other HPV assays identifying nucleic acid sequences of hrHPV types jointly or HPV assays detecting a limited number of HPV types, were also included, and other molecular markers (overexpression of proteins or methylation of certain viral or human genes) were also evaluated.…”

“…Eight reports had a prospective design, 5,7,8,31,[33][34][35][36] and 17 reports had a retrospective design. 6,15,29,30,[37][38][39][40][41][42][43][44][45][46][47][48][49] Eighteen studies included women with ASC-H identified through primary screening, 6,7,[29][30][31]33,[36][37][38][39][40][43][44][45][46][47][48][49] and 7 studies recruited subjects in colposcopy clinics to which women had been referred because of a prior cytological result of ASC-H. 5,8,15,34,35,41,42 Most included studie...…”

“…15 Nineteen studies reported accuracy data for the HC2 assay (Digene Corp, Gaithersburg, Md). [5][6][7][8]15,[29][30][31]33,[35][36][37][38][39][40][41]44,46,49 Four studies reported accuracy data for other hrHPV DNA testing; they included 2 using Linear Array HPV genotyping (Roche Molecular Diagnostics, Almeda, Calif), 34,50 1 using the Cervista HPV HR test (Hologic, Marlborough, Mass), 47 and 1 using multiplex polymerase chain reaction with genotypespecific primers (Eurofins MWG Operon, Huntsville, Ala). 42 For 2 studies, accuracy data were obtained for HPV-16/18 genotyping.…”