DNA ploidy measurement and human papillomavirus in abnormal cervical cytology

AbstractObjectiveTo compare the efficacy of high‐risk human papillomavirus (HR‐HPV) and DNA image cytometry (DNA‐ICM) status for identifying high‐grade cervical intraepithelial neoplasia or worse (≥CIN2).MethodsThis cross‐sectional study was performed in women undergoing follow‐up procedure after a previous abnormal cervical cytology. Cervical cells were collected for HPV detection and DNA ploidy measurement. Biopsy samples were taken for histological confirmation. Sensitivity and specificity values for ≥CIN2 detection with HR‐HPV and DNA‐ICM were determined.ResultsHR‐HPV was present in 74.5% of the women. The most frequent HPV infection was HPV 16, followed by HPV 31, 33 and 58. Aneuploidy was observed in 60.6% of all cases. Referral cytology revealed 78.0% sensitivity and 68.6% specificity for detecting a ≥CIN2 lesion. The HR‐HPV test alone showed 92.7% sensitivity, albeit it was not statistically different from DNA‐ICM (88.1%, P > .05). Positivity for HPV or DNA‐ICM resulted in 100% sensitivity. Higher specificity was observed for the combination of HR‐HPV and DNA‐ICM (88.6%), with no difference from DNA‐ICM alone (85.7%, P > .05).ConclusionDNA‐ICM or HR‐HPV positivity identified all cases of ≥CIN2 in women undergoing follow‐up procedure after a previous abnormal cervical cytology. Routine cervical cancer screening could be improved by the incorporation of DNA‐ICM as a complementary method to primary screening to identify which women need closer follow‐up.