Nowadays the HPV test is conducted to clarify conspicuous clinical data or primary abnormal PAP-test. For research of the timely risk assessment at the genesis of cervix carcinoma we compared retrospective the conventional cytology and the HPV detection in the routinely screening.
Between June and December 2012 a total of 32261 women had a cytological result by conventional cytology from our laboratory. For this study, we investigated the cytological result, which was supplemented with high-risk HPV typing result (cobas® HPV Test; F.Hoffmann-La Roche AG) from the same laboratory within one year. The results of conventional cytology were grouped in four categories: negative for intraepithelial lesions or malignancy (NILM), low grade intraepithelial lesions (LSIL), high grade intraepithelial lesions (HSIL) and atypical squamous cells of undetermined significance (ASC-US). The results of the comparison were evaluated as statistically significant at p <0,05 (NCSS Statistical Software).
1,2% of the women (n=376) had a cytology report accomplished with high-risk HPV result within one year. The average period between cytology results and HPV typing was 2,1 months. The mean age of the 376 women was 39,6 years (between 16 and 84 years). 72,3% of the women had a result negative for intraepithelial lesions or malignancy (272/376). 65,7% of the women were high risk HPV negative (247/376). There was a statistically significant difference (p=0,04867; Chi-Square test) between the positive/negative results of conventional cytology and the positive/negative results of high-risk HPV detection (104/272 to 129/247). More than half of the women were negative for both tests (n=211; 56,1%). 68 women were positive for both tests (18,1%). 36 women had a positive cytological report (5 ASC-US cases and 31 LSIL cases) and were high-risk HPV negative (9,6%). 16,2% of the women (n=61) were high-risk HPV positive but there were no intraepithelial lesions registered .
As expected all women with high grade intraepithelial lesions were high-risk HPV positive. The high-risk HPV negative women with reports of low grade intraepithelial lesions or atypical squamous cells of undetermined significance were probably infected with other HPV types (low-risk HPV is most to be expected). The high incidence of high-risk HPV positivity in women with negative cytology report clearly shows the utility of HPV typing for the objective risk assessment concerning the genesis of the cervix carcinoma.