Polymerase chain reaction and direct DNA tests in detection of human papillomavirus (HPV) DNA in cytologically normal and abnormal cervical smears. Scandinavian Multicenter Study Group

Abstract

The detectability of human papillomavirus DNA from cervical smears was studied by DNA tests of varying sensitivity. The results were correlated with cervical cytologic abnormalities. A total of 326 women examined at the gynecological outpatient clinics of five Scandinavian hospitals were enrolled in the study on the basis of previous pathological cervical smear or clinically suspected human papillomavirus (HPV) infection. The cervical smears were examined for HPV-DNA of types 6/11, 16 or 18 by two direct DNA tests, the AffiProbe HPV test and the ViraType test. The proportion of HPV-DNA-positive women with normal cytology, benign atypia (mild nuclear and cytoplasmic changes without signs of dysplasia) and dyskaryosis were 16% (12/77), 27% (42/156) and 37% (30/81), respectively. The smears negative for HPV types 6/11, 16 or 18 and those yielding discrepant results in the two commercial tests were also analysed by the polymerase chain reaction (PCR) method. By PCR analysis, the HPV 6/11, 16 or 18 DNA positivity increased from 27% to 41%. The increase was particularly pronounced among the women with dyskaryosis in cytology.