Hybrid capture II for high-risk human papillomavirus DNA testing to detect cervical precancerous lesions: A qualitative and quantitative study

Abstract

Hybrid capture Ⅱ (HC-Ⅱ) is the only technique that can be used in clinical human papillomavirus (HPV) DNA detection. However, there is controversy in regards to how to analyze and assess the viral load of high-risk (HR)-HPV by use of HC-Ⅱ and the relation between viral load and cervical lesions. In this study, we analyzed the results of a sequential screening of outpatients at the Department of Obstetrics and Gynecology of the China-Japan Friendship Hospital, and we aimed to explore the relationship between HR-HPV viral load and the severity of cervical lesions, and to clarify the clinical significance of the titer of HR-HPV DNA determined by HC-Ⅱ. Using HC-II, 2,761 women were screened for HR-HPV DNA combined with cytological testing using liquid-based cytology. All women with HR-HPV-positive results or abnormalities in cytology underwent a cervical biopsy through colposcopy. Cervical biopsies were taken in 1,051 women. The HR-HPV infection rate was 78.35% (76/97) in HPV-associated lesions, 87.33% (193/221) in cervical intraepithelial neoplasia (CIN) Ⅰ, 94.74% (144/152) in CIN Ⅱ, 100% (178/178) in CIN Ⅲ and 100% (20/20) in invasive cervical cancer (ICC), respectively (P<0.05). Based on the criteria of histopathology, the sensitivity of HR-HPV DNA testing by HC-Ⅱ for detecting high-grade cervical lesions was 97.71%, the specificity was 79.64%, the positive-predictive value was 41.06% and the negative-predictive value was 99.59%. The viral loads of HR-HPV DNA were 512.15±764.19 in HPV-associated lesions, 753.95±978.27 in CIN Ⅰ, 871.08±1003.52 in CIN Ⅱ, 603.40±740.25 in CIN Ⅲ and 466.44±673.05 in ICC, respectively. In conclusion, the positive rate of HR-HPV increased significantly in accordance with the severity of cervical lesions. The viral loads of cervical inflammatory lesions were markedly lower than CINs and ICC. The viral loads of HR-HPV DNA tested by HC-Ⅱ had no correlation with the grade of cervical lesions.

Cervical Neoplasia: Papillomavirus Infection and Resistance to Anti Tumor Immunity

“…Koilocytosis, bi-nucleation and dyskeratosis were observed in intraepithelial neoplasias of the cervix at relatively the following frequency of 92.24 and 46% in this study. During the study on the quantitative and qualitative detection of Papillomavirus in precancerous lesions of the cervix, the authors observed koilocytosis in a frequency of 61.2% of intraepithelial neoplasms of the cervix [61]. In a study looking for papillomavirus infection in women from Lubumbashi, the authors found the presence of koilocytosis in 92.7% of cases of intraepithelial neoplasia.…”

Evaluating the Performance of Hybrid Capture 2 Test as a Primary Screening Test from Studies Conducted in Low and Middle-Income Country Settings- Special Focus India

“…Total of 38 studies were excluded with reasons -22 studies were clearly excluded as articles did not fulfill the inclusion criteria for study settings. 16 studies from LMICs were excluded with reasons: Studies reported test characteristic of HC2 on hospital based data (Sodhani et al, 2006;Ma et al, 2010;Bhatla et al, 2012), study had no clarity on type of settings (Katyal et al,2011), studies reported estimates of HC2 on CIN3+ lesion only (Moy et al, 2010;Belinson et al, 2011;Nieves et al, 2013), studies mentioned no estimates of test characteristics of HC2 test or CI intervals (Schiffman et al, 2000;Sankaranarayanan et al, 2009;Cagle et al, 2010;Li et al, 2010;Girianelli et al, 2006), duplicate data, cytology as gold standard (Belinson et al, 2001;Blumenthal et al, 2001;Longatto-Filho et al, 2012;Katanga et al, 2019). Total 18 population based cross-sectional studies fulfilling the eligibility criteria were included in the analysis.…”