Clinical Validation Of High Risk HPV DNA Testing Versus Cytology For Predicting Cervical Cancer

Objective: Cervical cancer and its precancerous lesions are caused by persistent high risk human papilloma virus(HPV)infection.Some studies suggest that HPV test is safe,effective and sensitive than cytology.Considering the previously published literature draw that conclusion only based on taking CIN2/3 and above as the endpoint rather than that cervical carcinoma itself,this study was conducted to compare the validity of the high risk HPV test to Thinprep cytologic test for predicting cervical cancer.We undertook a retrospective research of cases of histologically confirmed cervical cancer with ThinPrep cytological results and hr-HPV DNA testing results were observed in patients 1 year ago,verifing backward clinical validation of high risk HPV DNA testing versus cytology for predicting cervical cancer.Methods: 247 Cases with a histologic diagnosis of invasive cervical carcinoma were retrieved from the Second Hospital of Hebei Medical University from January 2004 to September 2015.In our study,164 patients with histologically diagnosed cervical carcinoma and Pap cytology and/or HPV testing in the year prior to diagnosis were retrospectively studied.Pap cytology was performed using liquid-based preparations and the bethesda system and HPV testing was done with mostly Cape and roche(Cobas?)but also included rarely Hybrid Capture 2.Results: Taking ASCUS and above as the postive,cytological results was negative in 17.4% of 132 cases one years before the histological diagnosis.The negative rate of squamous cell carcinoma and adenocarcinoma were 15.5% and 21.1% respectively.HPV was negative in 13.3% of 120 cases.The HPV negative rate of adenocarcinoma was higher than that of squamous cell carcinoma(47.1% vs 6.1%).In 88 patients had both HPV test and cytology results,14(15.9%)cases were HPV negative,but only 4(4.5%)cases were negative.Conclusions: HPV screening for identifying cervical cancer has a relatively high negative rate,especially adenocarcinoma.when making screening recommendations with the understanding that HPV testing alone will miss at least a proportion of women with incident cervical carcinoma,cytology and HPV test combination is better than HPV test alone for cervical cancer prevention and primary screening.