Validity parameters of the HPV detection tests HC2 and APTIMA with and without cytology smears after surgical treatment of high grade cervical intraepithelial neoplasia lesions

J Hansen; J Waibel; A Clad; M Oehler; M Klar

doi:10.1055/s-0036-1592970

Geburtshilfe und Frauenheilkunde, Inhaltsverzeichnis

Validity parameters of the HPV detection tests HC2 and APTIMA with and without cytology smears after surgical treatment of high grade cervical intraepithelial neoplasia lesions

J Hansen ¹, J Waibel ¹, A Clad ¹, M Oehler ², M Klar ¹^,²

¹Universitäts-Frauenklinik Freiburg, Freiburg, Deutschland
²Women's Health Centre, Gynaecological Oncology, Adelaide, Australien

Abstract

Objectives: After surgical management of cervical intraepithelial neoplasia (CIN) lesions, HPV DNA or mRNA tests may provide better validity parameters than cytology smears alone.

Methods: 266 women with a suspicious colposcopy finding during follow-up examinations after surgical treatment of CIN lesions were included into this study. Routine cytology and HPV genotyping smears were obtained. Digene Hybrid Capture 2 (HC2) HR-HPV DNA, APTIMA HPV assays and cervical biopsies of suspect areas were performed. Validity parameters including positive and negative predictive values (PPV, NPV) were calculated using the cervical biopsy result as the gold standard.

Results: The median follow-up time was 25 months and the post-treatment recurrence rate of CIN II or III was 17.3%. For CIN II recurrences, NPV/PPV for HC2 was 0.93/0.44, for APTIMA 0.94/0.58 and for cytology 0.91/0.62 For CIN III recurrences, NPV/PPV for HC2 was 0.98/0.18, for APTIMA 0.98/0.25 and for cytology 0.99/0.36. Combined testing improved all NPVs and PPVs.

Discussion: In this study, HC2, APTIMA, and cytology smears showed excellent NPVs and moderate PPVs in the follow-up of CIN patients. The combination of HPV test with cytology improved all validity parameters.