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Type: Artigo de periódico
Title: Human Papillomavirus Viral Load In Predicting High-grade Cin In Women With Cervical Smears Showing Only Atypical Squamous Cells Or Low-grade Squamous Intraepithelial Lesion.
Author: Santos, André Luis
Derchain, Sophie Françoise
Martins, Marcos Roberto
Sarian, Luís Otávio
Martinez, Edson Zangiacome
Syrjänen, Kari Juhani
Abstract: Human papillomavirus (HPV) viral load may have an important role in predicting high-grade cervical intraepithelial neoplasia (CIN) in women with cervical smears showing atypical squamous cells or LSIL. To determine whether the assessment of the viral load of high-risk HPV DNA is useful in predicting the detection of high-grade cervical intraepithelial neoplasia (CIN2 and 3) in women referred because of cervical smears showing only atypical squamous cells or LSIL. Cross-sectional. Colposcopy Clinic in a University hospital. A series of 119 women referred because of atypical squamous cells or LSIL between August 2000 and April 2001 were included. All women were subjected to a new cervical smear, HPV testing for the high-risk types using hybrid capture II (HCII), viral load measurement in relative light units (RLU) and colposcopy, with cervical biopsies (n = 97). Cervical lesions were graded using the CIN classification. Cervical biopsies revealed CIN2 or CIN3 in 11% of the cases, equally among women referred because of atypical squamous cells or LSIL. The HCII test was positive in 16% of women with atypical squamous cells and 52% of those with LSIL (OR = 5.8; 95% CI 1.4 to 26.7). There was strong correlation between CIN2 or CIN3 and positivity for HPV DNA when this group was compared with women with only CIN1 or normal cervix (OR = 7.8; 95% CI 1.5 to 53.4). In ROC analysis for HCII in diagnosing CIN2 and CIN3, the area under the ROC curve was 0.784, and the viral load cutoff point of 10.0 RLU/cutcuff presented 77% sensitivity and 73% specificity. Second cytology showing at least atypical squamous cells did not accurately detect CIN2 or CIN3 (OR = 6.4; 95% CI 1.0 to 50.9). The sensitivities of the second cervical smear and HCII were similar, although the specificity of HCII was significantly higher than the second cervical smear. 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.
Subject: Adolescent
Cervical Intraepithelial Neoplasia
Cross-sectional Studies
Dna, Viral
Middle Aged
Neoplasms, Squamous Cell
Predictive Value Of Tests
Uterine Cervical Neoplasms
Vaginal Smears
Viral Load
Rights: aberto
Identifier DOI: /S1516-31802003000600004
Date Issue: 2003
Appears in Collections:Unicamp - Artigos e Outros Documentos

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