Results : Among 681 women with biopsy specimens showing cervical intraepithelial neoplasia and in 470 with cervical carcinoma, 73.4% and 76.4% had high-risk HPV DNA detected

.

.

.

ASCUS (atypical squamous

cells of undetermined significance)

(LSIL) .

1,2

(CINII) .

(HPV) (HSIL)

3,4

HPV

. Department of Obstetrics and Gynecology, Laboratory Medicine ,

Chonnam National University Medical School, Gwangju, Korea

Objective : To evaluate the utility of human papillomavirus (HPV) DNA detection, we conducted a study to determine accuracy of Hybrid capture test kit for detection of cervical intraepithelial neoplasia and cancer by biopsy results.

Methods : We enrolled women referred to a colposcopy clinic. All 2010 women had a sample for HPV DNA test and underwent colposcopically directed biopsies or loop electrode excision procedure. We used the Hybrid capture I test kit for HPV testing.

Results : Among 681 women with biopsy specimens showing cervical intraepithelial neoplasia and in 470 with cervical carcinoma, 73.4% and 76.4% had high-risk HPV DNA detected. Of 163 women with ASCUS on Papanicolaou smear, 65.8% had high-risk HPV DNA detected, and of 232 with low-grade squamous intraepithelial lesions, 48.0% had high-risk HPV detected.

Conclusion : High-risk HPV testing appears to be of value to identify women with high grade cervical intraepithelial lesion and cervical cancer. But it does not appear to be of value to identify women with low-grade squamous intraepithelial lesions.

Key Words : Human papillomavirus, Hybrid capture test, Cervix cancer

.

HPV HSIL

. (CIN

I) 60%

.⁵ CIN

.

FDA (Food and Drug Administration) Hybrid capture test I kit

HPV HPV DNA

.

1996 1 2000 12

cytobrush

HPV HSIL

. 12

12

. Bethesda system ,⁶

, CIN I, , .

Hybrid capture test I (Digene, MD, USA) cytobrush

Collection tube (Digene, MD,

USA) -20 .

HPV (16, 18, 31, 33, 35, 45, 51,

52, 56) .

DNA

HPV RNA

RNA/DNA hybrid coating

. RNA/DNA hybrid-

alkaline phosphatase-conjugated antibody

dioxetane-based chemiluminuscent

substrate alkaline phosphatase Lumi- Phospho 530

luminometer (Berthold, Germany)

. HPV 16 DNA 10 pg/

ml HPV

.

1.0 , 1.0

.

chi square test

p<0.05 .

2010

HPV DNA

. HPV DNA 1162 (57.8%)

HPV 29.4%

CIN I, , , 38.2%, 55.8%, 73.4%, 76.4%

CIN I, , HPV DNA

(Table 1).

HPV + HPV -

Histology Total No. (%) No. (%) p

Negative 527 155 (29.4) 372 (70.6) CIN 212 81 (38.2) 131 (61.8) 0.0194 CIN 120 67 (55.8) 53 (44.2) 0.0000 CIN 681 500 (73.4) 181 (26.6) 0.0000 Carcinoma 470 359 (76.4) 111 (23.6) 0.0000 Total 2010 1162 (57.8) 848 (42.2)

CIN , , HPV

79.7% 50 86.6%

50 75.7% HPV .

5 50

91.2% 50 80.3%

(Table 2).

Histology

CIN / , CA Total (%) Age 50 (%) Age<50 (%) HPV - 345/ 848 (40.7) 102/232 (44.0) 243/616 (39.4) HPV + 926/1162 (79.7) 369/426 (86.6) 557/736 (75.7) 5 ^# 559/ 662 (84.4) 229/251 (91.2) 330/411 (80.3) 10 ^# 442/ 521 (84.8) 182/196 (92.9) 260/325 (80.0) CIN , : cervical intraepithelial neoplasia, CA: carcinoma.

p<0.01 ^#: relative concentration to control.

ASCUS, LSIL

CIN , , HPV

65.8%, 48.0%

ASCUS HPV

(p<0.0001)(Table 3).

Histology

Cytology HPV No. CIN / , Carcinoma p

ASCUS + 76 50 (65.8%)

ASCUS - 87 28 (32.2%) 0.0001

LSIL + 152 73 (48.0%)

LSIL _ 80 30 (37.5%) 0.1213

ASCUS: atypical squamous cells of undetermined significance.

LSIL: low-grade squamous intraepithelial lesion.

600 ⁷

.

15-45% .⁸

HPV DNA .⁹

1977 HPV

HPV .¹⁰

CIN HPV

11 HPV CIN

8-11 HPV

LSIL HSIL .¹²

Kulasingam ¹³ CIN HPV

DNA Thinprep

Hybrid capture test HPV

ASCUS

CIN 3.2%

ASCUS Thinprep

61.3% Hybrid capture test

90.8% . 78.8% 72.6%

. HPV Thinprep HPV DNA

. Hughes ¹⁴

HSIL 71% PCR

HPV 87.5%,

72.5% .

Hybrid capture I test

74.6% . 25.4% HPV DNA

HPV DNA 38.2%

Hybrid capture test .

HPV DNA

.^15,16

HPV 608

1 PCR 70%

24 91%

31

. HPV DNA 81% 6

HPV .¹⁷

14.9

30 65% HPV 24

32% HPV

.¹⁸

CIN

50

HPV DNA HPV

DNA 50

HPV DNA .

LSIL ASCUS

. LSIL CIN

.

2,000,000 ASCUS 5-10%

.¹⁹

ASCUS LSIL

CIN 11.1%

HPV DNA 87.5% CIN

.²⁰

Cox ²¹ ASCUS LSIL

HPV HSIL

Lachman ²² ASCUS 560

90 36.2%

63.8% LSIL 53.7%,

HSIL 46.3% .

ASCUS 163

CIN ,

78 64.18% HPV

DNA .

LSIL CIN

HPV DNA

Vira Pap²³ 60% Hybrid capture test

24 80% .

LSIL

CIN ,

103 HPV DNA

70.9% . CIN

ASCUS 35.9% LSIL

29.1% Hybrid capture test I

HPV DNA .

ASCUS LSIL

Hybrid Capture test HPV DNA

.

2010

Hybrid capture test I HPV

DNA , CIN I, CIN , CIN

, 29.4%, 38.2%, 55.8%, 73.4%, 76.4%

HPV DNA

. CIN

HPV DNA 50 5

ASCUS CIN

HPV DNA 65.8%

LSIL 48.0% .

Hybrid capture test I

HPV DNA CIN , ,

CIN I HPV DNA .

:

.

: 2010 Hybrid Capture test I HPV DNA

.

: CIN 73.4% 76.4%

ASCUS LSIL CIN 65.8% 48.0% .

: Hybrid capture test I

. , , Hybrid capture test