Human papilloma virus testing in women with an abnormal Pap smear
Genome-Wide Association Study
Nucleic Acid Amplification Techniques
With the knowledge that a lower genital tract infection with the HPV is the initiator of subsequent abnormal cervical cellular changes, we wanted to evaluate the role of HPV testing in women with initial Pap smear reports of ASCUS, L-SIL or H-SIL. 266 patients were evaluated in this study (December 1996-October 2003), 131 had an initial cytology report of L-SIL or H-SIL, while 135 had a report of ASCUS. HPV was initially tested by PCR, in a second time it was tested by a DNA hybridisation assay. Patients with L-SIL and an initial positive HPV test that became negative had a good prognosis. Patients with an initial positive HPV test that remained positive on subsequent testing had more abnormal follow up Pap test. HPV testing was more predictive in patients with an initial ASCUS cytology report. The results of this observational study confirm observations from other studies. A negative report for HPV in patient with a L-SIL or H.SIL pap smear report does not eliminate the possibilities of cervical cellular abnormalities. Patients with an L-SIL or H-SIL pap will usually require colposcopy and biopsy, in women with an initial ASCUS report, a negative HPV test identifies a population that can be followed with subsequent Pap smears, without immediate resort to colposcopy and biopsy. In the future, HPV testing could be used in all sexually active women, not limited to those with an abnormal cervical cytology reports. © Copyright 2004, CIC Edizioni Internazionali, Rome.
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