Tbe presence of certain HPV types in the female genital tract was associated with a number of diseases, including condyloma, cervical, vaginal and vulvar intraepithelial neoplasia and carcinoma. It is generally accepted that these viruses are predominantly sexually transmitted. HPV cannot be cultured in vitro, and immunological tests are inadequate. Indirect evidence of anogenital HPV infection can be obtained through the physical examination and by the presence of characteristic cellular changes associated with viral replication in Pap smear or biopsy specimens. Alternately cervical scrapes can be analyzed by nucleic acid hybridization to directly detect the presence of HPV DNA, Historically, HPV 16 and HPV 18 have been regarded as high risk cancer associated HPVs and HPV types 6, 11, 42, 43 and 44 as low risk HPVs. Subsequently HPV types 31, 33, 34, 35, 45, 51, 52, 56 and 58 have been demonstrated to have and intemediate association with cancer, This study was performed for high and intermediate types HPV DNA detection on cervical carcinoma with Virapap Probe B. HPV DNA were detected 82.3% on cervical carcinoma and 7,1% on control samples. HPV DNA test will be apply as a triage for cervical cancer detecting test.
Biopsy ; DNA ; Female ; Human papillomavirus 16 ; Human papillomavirus 18 ; Human Papillomavirus DNA Tests ; Humans* ; Immunologic Tests ; Nucleic Acid Hybridization ; Papilloma* ; Physical Examination ; Triage ; Uterine Cervical Neoplasms*

PURPOSE: The purpose of this study is to evaluate the impact of high-risk human papillomaviruses (HPVs) other than HPV 16/18 on the natural course of atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL). MATERIALS AND METHODS: The study population was derived from the Korean HPV cohort (2010-2014). Women aged 20 to 60 who satisfied the criteria of having both HPV infection and abnormal cervical cytology of either ASC-US or LSIL were recruited from five institutions nationwide. Enrolled patients underwent cervical cytology and HPV DNA testing every 6 months. RESULTS: A total of 1,158 patients were enrolled. The 10 most common HPV types were HPV 16 (12.3%), 58 (10.0%), 56 (8.8%), 53 (8.4%), 52 (7.7%), 39 (6.2%), 18 (6.0%), 51 (5.7%), 68 (5.1%), and 66 (4.6%). Among these patients, 636 women were positive for high-risk HPVs other than HPV 16 or 18, and 429 women were followed for more than 6 months. Cytology evaluations showed progression in 15.3% of women, no change in 22.6%, and regression in 62.1% of women at 12 months. In cases of HPV 58 single infection, a more highly significant progression rate, compared to other high-risk types, was observed at 6 months (relative risk [RR], 3.3; 95% confidence interval [CI], 2.04 to 5.30; p < 0.001) and 12 months (RR, 5.03; 95% CI, 2.56 to 9.91; p < 0.001). CONCLUSION: HPV genotypes numbered in the 50s were frequent in Korean women with ASC-US and LSIL. HPV 58 was the second most common type, with a high progression rate of cervical cytology.
Atypical Squamous Cells of the Cervix ; Cohort Studies* ; Female ; Genotype* ; Human papillomavirus 16 ; Human Papillomavirus DNA Tests ; Humans ; Squamous Intraepithelial Lesions of the Cervix

OBJECTIVE: Since the accuracy of Pap smear for cervical neoplasm has been questioned, a number of adjunctive tests have been developed. The purpose of this study was to evaluate which protocol is the most effective screening test among cervical cytology (ThinPrep(R)), HPV DNA test (Hybrid capture(R) II) and cervicography. METHODS: We chose 252 patients who were underwent the biopsy among 829 patients who visited our hospital for cervical cancer screening test. These 252 patients were engaged in this study simultaneously. They underwent triple combined test [cervical cytology (ThinPrep(R)), HPV DNA test (Hybrid capture(R) II), cervicography] and colposcopic-directed biopsy or biopsy on operation for diagnostic evaluation. RESULTS: The triple combined test showed a sensitivity of 96.0%, while double combined test [cervical cytology (ThinPrep(R))+cervicography] showed a sensitivity of 89.0%, the other double combined test [cervical cytology (ThinPrep(R))+HPV DNA test (Hybrid capture(R) II)] showed a sensitivity of 86.7%. Cervicography showed a specificity of 75.4% (highest among the single test), positive predictability of 89.8% (also highest). CONCLUSION: The sensitivity of cervical cytology was markedly improved by combination with HPV DNA test and cervicography. So the triple combined tests which improved the high false negative rate of cervical cytology may be a new effective method as a cervical cancer screening test, if the effectiveness could be confirmed by mass screening study.
Biopsy ; DNA ; Human Papillomavirus DNA Tests* ; Humans ; Mass Screening* ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

OBJECTIVE: This study was performed to evaluate the clinical efficacy of high risk HPV DNA test using PCR for the detection of high-grade CIN or invasive cancer from patients with ASCUS or LSIL on Papanicolaou smear. METHODS: Sixty one patients with a Papanicolaou smear report of atypical squamous cells of undetermined significance or a low-grade squamous intraepithelial lesion underwent Cervical colposcopy and directed cervical biopsy and human papillomavirus test by PCR. We compared the detection rate of the high grade CIN and invasive cancer by Papanicolaou smear method only with that of both Papanicolaou smear and HPV PCR method. and we decided to be significant when P value was below 0.05 by SAS (v 6.02) program. RESULTS: The detection rate of high risk HPV DNA was 50.8% (31/61). The detection rate of high risk HPV DNA in high grade CIN and invasive cancer was 84.2% (16/19). Higher the grade of biopsy, more the detection rate of high risk HPV DNA. False negative rate which appeared high grade CIN or invasive cancer by biopsy was 31.2% (19/61) in Papanicolaou smear method only and 4.9% (3/61) in both Papanicolaou smear and HPV DNA method. CONCLUSION: We thought that additional HPV DNA test was useful to dectect behind high grade CIN or invasive cancer when the Papanicolaou smear result was ASCUS or LSIL.
Biopsy ; Colposcopy ; Diagnosis* ; DNA ; Human Papillomavirus DNA Tests* ; Humans ; Papanicolaou Test ; Polymerase Chain Reaction

OBJECTIVE: Human papillomavirus (HPV) test was incorporated into the triage of lesser abnormal cervical cytologies: atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL). This study aimed to evaluate the impact of age on the efficacy of HPV testing in patients with lesser abnormal cervical cytologies. METHODS: A total of 439 patients with ASCUS or LSIL were included. The association between age groups and the diagnostic performances of HPV test for high-grade cervical intraepithelial neoplasia (CIN2+) was evaluated. RESULTS: Median age was 44 years (range, 17 to 75 years). ASCUS was more frequently observed in older patients while LSIL was more common in younger patients (P=0.002). CIN2+ was found in 11.3% (32/284) of the ASCUS patients and 12.9% (20/155) of patients with LSIL. Older patients with ASCUS showed lower HPV infection rates (P=0.025), but not LSIL (P=0.114). However, the prevalence of CIN2+ was similar between the age groups with ASCUS or LSIL. In patients with ASCUS, the false negative rate of HPV test for CIN2+ was 6.2%. The false negative rate of the HPV test became higher with increasing of the age after the age of 50 (P=0.034). CONCLUSION: Our findings suggest that false negative rate of the HPV test for CIN2+ in ASCUS patients older than 50 years might become higher with increasing of the age. Negative HPV results in patients of the age >50 years with ASCUS should be carefully interpreted.
Cervical Intraepithelial Neoplasia ; DNA* ; Human Papillomavirus DNA Tests ; Humans ; Prevalence ; Triage ; Uterine Cervical Dysplasia

OBJECTIVES: After LEEP conization of cervical precancerous lesions, cytologic follow-up and colposcopy is frequently unsatisfactory. This study was performed to investigate the relationship between the presence of human papillomavirus (HPV) and abnormal follow-up results. METHODS: Between March 1995 and Feburary 1999, 98 patients treated by LEEP for cervical dysplasia and CIS were included. All patient had initially done HPV testing by Hybrid Capture System (Digene Co., U.S.A.). Patients were followed up with PAP, colposcopy and HPV test. RESULTS: After mean follow-up 10.9-month follow-up, 9 patients (9.2%) had the abnormal cytology (>ASCUS). After treatment, there were 2 abnormal cytologic follow-up cases (13.3%) in the groups of koilocytosis and CIN I in initial tissue pathology, 7 abnormal follow-up cases (8.4%) in groups of CIN II/III and CIS. There was no significant difference between the recurrence rates of these two group (P=0.27). The presence of high-risk HPV DNA after LEEP was done in 26 cases. Of the HPV-positive follow-up cases, 4 patients (50%) had abnormal cytologic results. But none had abnormal cytology in HPV-negative patients. CONCLUSION: Participants with positive follow-up HPV test have a higher recurrence rate than those with negative HPV test. Our study suggests the value of supplementary HPV DNA testing during follow-up of patients treated for cervical precancerous lesions.
Colposcopy ; Conization ; DNA ; Follow-Up Studies* ; Human Papillomavirus DNA Tests ; Humans ; Pathology ; Recurrence

No abstract available.
Cervical Intraepithelial Neoplasia/*diagnosis ; Female ; Human Papillomavirus DNA Tests/*methods ; Humans ; Papillomavirus Infections/*diagnosis ; Uterine Cervical Neoplasms/*diagnosis

OBJECTIVE: To identify resection margin status and HPV DNA test as predictive factors for residual lesion in the management of CIN3 with cervical conization. METHODS: A retrospective study was conducted on 96 patients with CIN3 who had been performed cervical conization (LEEP or CKC) between January 1999 and December 2003 at Soonchunhyang university Chunan hospital. Secondary conization or hysterectomy were performed in case of positive margin on cone specimen or negative margin with other hysterectomy indication. Resection margin status and pre conization HPV DNA test were compared with residual lesion on subsequent cone or hysterectomy specimen. RESULTS: Among 96 cases, 24 cases (15.6%) showed positive resection margin on cone specimen. Of 24 cases with positive resection margin, 2 cases were followed up without treatment, 2 cases were treated with secondary conization and 20 cases were treated with hysterectomy. Of 72 cases with negative resection margin, hysterectomy was performed due to other indication in 16 cases. Persistence of residual lesion in the secondary conization and hysterectomy specimens was significantly correlated with high risk HPV infection and positive resection margin status (p<0.05). CONCLUSION: Conization is good treatment modality of the management of CIN3. HPV DNA test and resection margin status are good predictor of residual lesion after cervical conization for the management of CIN 3. Therefore, when HPV positive and resection margin positive, secondary treatment is mandatory.
Chungcheongnam-do ; Conization* ; Human Papillomavirus DNA Tests* ; Humans ; Hysterectomy ; Retrospective Studies

OBJECTIVE: This study was performed to evaluate the clinical efficacy of high-risk HPV DNA test using Hybrid Capture System in the detection of high-grade cervical intraepithelial neo- plasia(CIN II, III) from patients with atypical squamous cells of undetermined significance(ASCUS) or a low-grade squamous intraepithelial lesion(LGSIL) on referral Papanicolaou smear. STUDY DESIGN: Fifty-four patients referred to our hospital with a Papanicolaou smear report of atypical squamous cells of undetermined significance or a low-grade squamous intraepithelial lesion underwent repeat Papanicolaou smear, cervical colposcopy and directed cervical biopsy. In addition, high-risk human papillomavirus(HPV) test by Hybrid Capture System was done. A comparison of detection rate of the high-grade CIN between positive and negative results of HPV test according to repeat Papanicolaou smear report was done. Biopsy result according to HPV test result in total patients was also compared. RESULTS: HPV of high-risk type was detected in 22 of 54 women(40.7%) by Hybrid Capture System. Prevalence rate of high-risk HPV in no CIN, CIN I, and CIN II, III was 13.6%, 18.2% and 68.2% respectively. As expected, high-risk HPV was detected with greater frequency in relation to increasing severity of CIN. In 18 women, the repeat smear obtained in our clinic was reported as negative. High-risk HPV types were found in 16.7% of theses women. In the HPV-negative women, 40% had CIN II or III confirmed on cervical biopsy. In comparison, 66.7% of those with a positive result of the HPV test had CIN II or III on biopsy(P<0.05). Among the women with ASCUS or LGSIL on repeat smear, there was no significant difference in the frequency of biopsy-proved CIN II or III between positive and negative results of high-risk HPV test. In total patients, the group that had positive results for high-risk HPV showed higher incidence of CIN II or III than group with negative results(P<0.05). CONCLUSION: From these results testing women with Papanicolaou smears showing ASCUS or LGSIL for infection with high-risk HPV types would identify the patients who are at risk for HGSIL or invasive carcinoma and who require aggressive intervention. High-risk HPV DNA test using Hybrid Capture System may be a usefule method in supplement the pitfalls of cervical cytology. This test might also have prgnostic value in the management of patients with cervical intraepithelial lesions.
Biopsy ; Colposcopy ; Female ; Human Papillomavirus DNA Tests ; Humans* ; Incidence ; Papanicolaou Test ; Papilloma* ; Prevalence ; Referral and Consultation

OBJECTIVE: Our study was performed to assess prevalence of HPV infections in general female population of Korea and efficacy of HPV DNA test as an adjunctive screening of cervical cancer. MATERIALS AND METHODS: From January 2000 to December 2000, a total 689 patients who had undergone Pap smear and HPV DNA test using Hybrid Capture System-II were included in this study. High risk types of HPV included 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68. We performed colposcopic biopsy on 203 patients. RESULTS: High-risk oncogenic HPV infections were found in the 19.4% of the investigated patients. The sensitivity and negative predictive value of Pap smear alone in identifying the lesions more severe than CIN 2 was 72.2% and 83.2%, respectively. The combination of Pap smear and high risk HPV testing increased to 96.3% and 95.3%, respectively. CONCLUSIONS: The prevalence of HPV infection in general population was 19.4%. The use of HPV DNA testing significantly improved the sensitivity or negative predictive value of the diagnosis of high grade CIN or cancer. Thus, we suggest HPV DNA testing appears to be a needed adjunct to the Pap smear and a combined screening test offers the possibility of greater detection or longer screening intervals, which will be able to reduce the overall cost of the screening program.
Biopsy ; Diagnosis ; Female ; Human Papillomavirus DNA Tests* ; Humans ; Korea* ; Mass Screening* ; Prevalence* ; Uterine Cervical Neoplasms*