Specific HPV types are currently implicated as etiologic agents of precursors and cancerous lesions of the uterine cervix. This study used the data gained from data gained from 350 women who underwent concurrent cervical cytology, colposcopy and
HPV DNA
test in the Department of Obstetrics & Gynecology, Catholic University Medical College, Kangnam St. mary's Hospital from march 1994 to Febrary 1995.
Cytologic results showed that 222 patients had normal cytology, 55 patients had ASCUS, 40 patients had LGSIL, 29 had HGSIL, and 4 had cervical cancers.
Colposcopy-guided biopsy was done in 149 cases. DNAs extracted from the cervcal swabs were analyzed by hybrid Capture System, which cervical cells were tested with two pooled probes(probes containig HPV types of low oncogenic risk; 6, 11, 42, 43
and 44
or HPV types of high oncogenic risk; 16, 18, 31, 33, 35, 45, 51, 52 and 56) for HPV detection. The small fraction of DNA from each sample was also analyzed by polymerase chain reaction(PCR) using E6 primers of HPV-16 and HPV-18.
Using Hybrid Capture System, detection rates of HPV ss with low and high oncogenic risks in each group showed that the patients with nonspecific cervical lesions was 23.7%(50/211), patients with HPV infection was 31.9%(15/47), CIN-I 66.7%(10/15),
CIN-II
62.9%(22/35) and CIN-III 90.5%(38/42).
HPVs of high oncogenic risk type were detected in 120 of 350 women(34.3%) by Hybrid Capture System and 180 woman(51.4%) by PCR using HPV E6 primers of HPV-16/18. Prevalence rates of high risk HPVs in CIN-I, CIN-II and CIN-III were 66.7%(10/15),
60%(21/35) and 90.5%(38/42) by Hybrid Capture System and 86.7%(13/15), 74.3%(26/35) and 85.7%(36/42) by PCR, respectively. The detection rates of the two methods were not significantly different in patients with CIN-I, CIN-II and CIN-III(p>0.05).
Detection rates of high risk HPVs in patients with nonspecific cervical lesions and HPV infection were 19.4%(41/211) and 21.3%(10/47) by Hybrid Capture System, 33.7%(71/211) and 72.3%(34/47) by PCR, respectively. The detectability of HPVs in
these
lesions by PCR showed better sensitivity than Hybrid Capture System.
At each cytology group, the patients who had positive results for high risk HPVs with Hybrid Capture showed higher incidence of CINs than those with negative results(p<00.05). By quantative analysis using Hybrid Capture System, the patients with
high
viral titer(over the 3.0 RLU) in normal cytology had high incidence rate of CINs than those sith low viral titer.
From these results, Hybrid Capture System would be an idal method for identifying HPV DNAs especially in low-grade cervical lesions when compairing with PCR method. Also, this method provides another information on differentiating precancerous
lesions
of cervix into high- or low-risk of progression. This test might have prognostic value in the management of patients with HPV-related cervical intraepithelial lesions.
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