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      The cytology and DNA detection by the PapilloCheck® test in the diagnosis of human papillomavirus infection

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          Abstract

          The aim of this study was to make a comparison between the results obtained by cytologies and by the detection and genotyping of human papillomavirus (HPV) DNA in the screening of cervical cancer. In this study, there were 994 samples used from human females. These were obtained from liquid-based preparations. The samples were analyzed by cytological technique and by the detection of HPV DNA using the PapilloCheck® Test. The HPV was detected in 28% of the samples. Most of the cytology lesions appeared in HPV positive samples and, within these, the most serious injuries occurred mostly in samples with multiple HPV infections. The results indicate that, in general, there is a correlation between the detection of HPV DNA and cytology. However, there were some cases that emphasize the limitations of both diagnosis methods (27% cases with viral HPV DNA positive and normal cytologies and about 2% of cytological lesions detected in samples HPV negatives). It is possible to conclude that none of the two techniques is enough by itself and should be applied together in order to increase the accuracy of cervical cancer screening.

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          Most cited references24

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          Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis.

          We set out to estimate the age and genotype-specific prevalence of cervical human papillomavirus (HPV) DNA in women with normal cervical cytology worldwide by meta-analysis of a systematic literature review. Reports on HPV prevalence published between January, 1995, and January, 2005, were retrieved. To be included, studies required information on cervical cytology, plus detailed descriptions of study populations, methods used to collect cervical samples, and assays used for HPV DNA detection and typing. Final analyses included 78 studies that could be separated into women with normal cytology, and of which subsets of 44 and 48 studies had data on age and type-specific HPV prevalence, respectively. Overall HPV prevalence in 157 879 women with normal cervical cytology was estimated to be 10.4% (95% CI 10.2-10.7). Corresponding estimates by region were Africa 22.1% (20.9-23.4), Central America and Mexico 20.4% (19.3-21.4), northern America 11.3% (10.6-12.1), Europe 8.1% (7.8-8.4), and Asia 8.0% (7.5-8.4). In all world regions, HPV prevalence was highest in women younger than 35 years of age, decreasing in women of older age. In Africa, the Americas, and Europe, a clear second peak of HPV prevalence was observed in women aged 45 years or older. On the basis of these estimates, around 291 million women worldwide are carriers of HPV DNA, of whom 32% are infected with HPV16 or HPV18, or both. The HPV types most commonly detected are similar to those most commonly described in pre-neoplastic and cancer cases, although the relative contribution of HPV16 and HPV18 is substantially lower in cytologically normal women.
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            Human papillomavirus infections with multiple types and risk of cervical neoplasia.

            Besides an established role for certain human papillomavirus (HPV) genotypes in the etiology of cervical cancer, little is known about the influence of multiple-type HPV infections on cervical lesion risk. We studied the association between multiple HPV types and cervical lesions among 2,462 Brazilian women participating in the Ludwig-McGill study group investigation of the natural history of HPVs and cervical neoplasia. Cervical specimens were typed by a PCR protocol. The cohort's repeated-measurement design permitted the assessment of the relation between the cumulative and concurrent number of HPV types and any-grade squamous intraepithelial lesions (SIL) and high-grade SIL (HSIL). At individual visits, 1.9% to 3.2% of the women were infected with multiple HPVs. Cumulatively during the first year and the first 4 years of follow-up, 12.3% and 22.3% were infected with multiple types, respectively. HSIL risk markedly increased with the number of types [odds ratio (OR), 41.5; 95% confidence interval (95% CI), 5.3-323.2 for single-type infections; OR, 91.7; 95% CI, 11.6-728.1 for two to three types; and OR, 424.0; 95% CI, 31.8-5651.8 for four to six types, relative to women consistently HPV-negative during the first year of follow-up]. The excess risks for multiple-type infections remained after exclusion of women infected with HPV-16, with high-risk HPV types, or persistent infections, particularly for any-grade SIL. Coinfections involving HPV-16 and HPV-58 seemed particularly prone to increase risk. Infections with multiple HPV types seem to act synergistically in cervical carcinogenesis. These findings have implications for the management of cervical lesions and prediction of the outcome of HPV infections.
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              The 2001 Bethesda System terminology.

              The 2001 Bethesda System for reporting cervical or vaginal cytologic diagnoses is an incremental change in the uniform terminology introduced in 1988 and revised in 1991. The 2001 Bethesda System includes specific statements about specimen adequacy, general categorization, and interpretation and results. In the adequacy category, "satisfactory" and "unsatisfactory" are retained, but "satisfactory but limited by" is eliminated. The new category of "atypical squamous cells" (ASC) replaces the category of "atypical squamous cells of undetermined significance" (ASCUS) and is divided into qualifiers of (1) ASC of "undetermined significance" (ASC-US) and (2) "cannot exclude high-grade squamous intraepithelial lesion (HSIL)," or (ASC-H). The categories of ASCUS, "favor reactive" and "favor neoplasia" are eliminated. The terminology for low-grade squamous intraepithelial lesions (LSILs) and HSILs remains unchanged. The category of "atypical glandular cells of undetermined significance" (AGUS) is eliminated to avoid confusion with ASCUS and is replaced by the term "atypical glandular cells" (AGC), with attempts to identify whether the origin of the cells is endometrial, endocervical, or unqualified. "Endocervical adenocarcinoma in situ" and "AGC, favor neoplastic" are included as separate AGC categories. The presence of normal or abnormal endometrial cells is to be reported in women who are at least 40 years of age. Educational notes and comments on ancillary testing may be added as appropriate.
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                Author and article information

                Journal
                1886
                122234
                European Journal of Microbiology and Immunology
                EuJMI
                Akadémiai Kiadó, co-published with Springer Science+Business Media B.V., Formerly Kluwer Academic Publishers B.V.
                2062-509X
                2062-8633
                1 March 2013
                : 3
                : 1
                : 61-67
                Affiliations
                [ 1 ] Departamento de Biologia and CESAM, Universidade de Aveiro, 3810-193, Aveiro, Portugal
                Author notes
                [* ] +351 234 370 784, aalmeida@ 123456ua.pt
                Article
                9
                10.1556/EuJMI.3.2013.1.9
                515b2006-226f-4b1b-9034-e312f6ca3012
                History
                : 11 September 2012
                : 13 November 2012

                Medicine,Immunology,Health & Social care,Microbiology & Virology,Infectious disease & Microbiology
                cervical cancer,PapilloCheck® Test Kit,cytology,human papillomavirus

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