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Open Access Highly Accessed Research article

Hybrid capture vs. PCR screening of cervical human papilloma virus infections. Cytological and histological associations in 1270 women

Sotirios Tsiodras1, John Georgoulakis2, Aikaterini Chranioti23, Zanis Voulgaris4, Amanda Psyrri5, Angeliki Tsivilika6, John Panayiotides7 and Petros Karakitsos23*

Author Affiliations

1 4th Dept of Internal Medicine, Attikon University Hospital, University of Athens Med. Sch. Athens, Greece

2 Department of Cytopathology, Attikon University Hospital, University of Athens Med. Sch. Athens, Greece

3 Department of Histology and Embryology, University of Athens Med. Sch. Athens, Greece

4 1st Department of Obstetrics and Gynecology, University of Athens Med. Sch. Athens, Greece

5 Department of Internal Medicine and Oncology, University of Athens Med. Sch. Athens, Greece

6 Department of Cytopathology, Alexandra Hospital, Athens, Greece

7 2nd Department of Pathology, Attikon University Hospital, Athens University Medical School, Athens, Greece

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BMC Cancer 2010, 10:53  doi:10.1186/1471-2407-10-53

Published: 22 February 2010

Abstract

Background

We evaluated two molecular methods of HPV detection and their correlation with cytological and histological diagnosis in a large sample of Greek women.

Methods

All women with liquid-based cytology performed at a University Hospital between 2000 and 2003 were included. The Hybrid Capture 2 (HC2) kit and in house Polymerase Chain Reaction (PCR) were used for HPV DNA detection. Cervical biopsy was performed for women with ASCUS+ cytology, HPV detection, or abnormal colposcopy. Positive (PLR) and negative (NLR) likelihood ratios were calculated for cytology and HPV molecular testing for the prediction of CIN2 and greater histology.

Results

Of the 1270 women evaluated 241 (18.5%) had abnormal cytology. Cytology diagnosed high-grade squamous intraepithelial lesion (HSIL) or invasive carcinoma in 21(1.7%) cases whereas 26 (2%) women had CIN2+ or greater histology. PCR detected HPV in 397/1270 (31.3%) and HC2 in 260/1270 (20.4%) samples. Both molecular tests exhibited high reproducibility (Cohen's kappa value 0.691, 95% CI: 0.664 - 0.718). Positive likelihood ratios (PLR) of 9.4, 3.8 and 3.4 and negative likelihood ratios of 0.13, 0.21, and 0 were noted for ≥ LSIL, any positive HC2 or any positive PCR-HPV testing, for predicting CIN2+ histology, respectively. All CIN 3+ lesions harbored high risk oncogenic HPV type infections.

Conclusions

HPV infection was found in a large proportion of this population and was associated with CIN 2/3 lesions and infiltrating carcinomas. Thin prep testing and HPV detection by HC2 or PCR performed very well with regards to identifying high grade lesions in an environment with experienced examiners.