Comparison of PCR- and hybrid capture-based human papillomavirus detection systems using multiple cervical specimen collection strategies

Abstract

This study compared the performances of three human papillomavirus (HPV) detection tests with specimens collected by three alternative procedures. The HPV tests included the Hybrid Capture Tube test (HCT), the microplate-based Hybrid Capture II test (HC II), and the MY09-MY11 L1 consensus primer PCR-based assay. Initial cervical specimens were collected from study subjects with a broom device, and after Papanicolaou smears were made, residual specimens were placed into PreservCyt (PC), a liquid cytology medium. A second specimen was collected from each subject and placed into Digene Specimen Transport Medium (STM). The device for collection of the second specimen alternated with consecutive subjects between a conical cytology brush and a Dacron swab. At the 1.0-pg/ml cutoff, the results of the HC II agreed well with those of the PCR. Specifically, when PCR data were restricted to the types found by the HC II (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68), there was greater than 90% agreement between the HC II and PCR results with both STM and PC. At a lower cutoff (0.2 pg/ml), HC II-positive results increased further, especially when the test was applied to the PC specimens. However, false-positive HC II results were more often observed at the 0.2-pg/ml cutoff. HC II yielded the highest HPV positivity with specimens placed into PC, followed by specimens collected with a conical brush and placed into STM and, last, by those collected with a Dacron swab and placed into STM. Our results demonstrate the utility of both the STM and PC specimen collection methods and show good agreement between the HC II and PCR.

FIG. 1

Flowchart illustrating the cervical specimen collection and HPV testing strategies.

FIG. 2

Agreement between HPV test results of HCT, HC II, and PCR. The upper panel shows the percentages of specimens positive by HCT, HC II, and PCR. HCT and HC II results for all specimens collected with a conical brush or Dacron swab were combined. HC II and PCR results with PC liquid cytology medium specimens are also shown. In the lower panel, kappa statistics were calculated for HCT and HC II results compared to the PCR results. The results shown in the upper panel were used to derive the values shown in the lower panel. Only data for the HPV types present in the HC II Probe B cocktail (i.e., HPVs 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68) are presented.