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Human papillomavirus negative but dyskaryotic cervical cytology: re-analysis of molecular testing

Peevor, Richard J., Bowden, Sarah, Jones, Joanne, Fiander, Alison Nina and Hibbitts, Samantha Jayne 2009. Human papillomavirus negative but dyskaryotic cervical cytology: re-analysis of molecular testing. Journal of Clinical Virology 44 (4) , pp. 322-324. 10.1016/j.jcv.2009.01.015

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Background Evaluation of molecular Human Papillomavirus (HPV) testing into UK Cervical Screening Programmes is underway. In South Wales the current HPV prevalence in women attending routine screening is 13.5% with 76.3% HR HPV positive in cases with reported dyskaryotic cervical cytology [Hibbitts S, Jones J, Powell N, Dallimore N, McRea J, Beer H, et al. Human papillomavirus prevalence in women attending routine cervical screening in South Wales, UK: a cross-sectional study. Br J Cancer 2008;99(December (11)):1929–33]. Objectives The aim of this study was to re-analyse the 23.7% cases with reported dyskaryotic cytology that were HR HPV negative (n = 52 out of 219 in a population of 10,000). Study design Three procedures were performed: (i) GP5+/GP6+ PCR-EIA repeat on original DNA extracts; (ii) DNA extraction and GP5+/GP6+ HPV PCR-EIA; (iii) DNA extraction and HPV typing using Greiner Bio-One™ PapilloCheck DNA microarray. Results 51 out of 52 samples were re-analysed. Direct repeat HPV PCR-EIA identified 24% (n = 12/51) of samples positive for HR HPV. Re-extracted DNA and PCR-EIA increased detection to 41.2% (n = 21/51) and PapilloCheck detected 78.4% (n = 40/51). HR HPV detection by PapilloCheck was significantly higher compared with the other methods of re-analysis. Eleven samples were persistently HR HPV negative but 4 tested positive for low risk HPV. Conclusions This study identifies that up to 78% of samples with dyskaryotic cervical cytology that test negative for HPV can be found to be HPV positive on re-analysis. The reliance on a single negative HPV test result could lead to missed HPV related disease in a subset of patients, the number dependant on which HPV test is performed. The clinical significance of a false negative HPV result depends on the screening interval and how HPV testing is incorporated into screening.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > RG Gynecology and obstetrics
Uncontrolled Keywords: human papillomavirus, HPV testing, cervical screening, dyskaryosis, HPV negative
Publisher: Elsevier
ISSN: 1386-6532
Last Modified: 07 Jul 2020 13:48

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