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Validating polymerase chain reaction for detecting HPV in cervical intraepithelial neoplasia
Elva I Cortés-Gutiérrez1, Ricardo M Cerda-Flores, Diana S Leal-Klevezas
1Genetics Division, Centro de Investigación Biomédica del Noreste, and Obstetrics and Gynecology Hospital, Instituto Mexicano del Seguro Social, Mexico. elvairenecortes@hotmail.com
Objective:
To validate polymerase chain reaction (PCR) analysis for detecting HPV in Mexican women with cervical intraepithelial neoplasia, grade 2 and 3 (CIN 2/3) versus histologic evidence.
Study Design:
A diagnostic test study was carried out. A sample of 25 selected women who were diagnosed by histology as having CIN 2/3 was analyzed. Biopsies were examined for HPV infection using light microscopy. The histologic criteria used for HPV infection included koilocytosis, dyskeratosis cells, bi/multinucleation, and parakeratosis. PCR was performed on each sample using commercial probes (MY09 and MY11), and then HPV typing was carried out by restriction fragment length polymorphism analyses.
Results:
PCR revealed that 88% (22/25) of the women were HPV positive (19 high risk and 3 low risk). In contrast, histology revealed that 28% (7/25) of the women were HPV positive. The number of women infected with HPV was 3.14 times (88/28) more frequently detected with PCR procedure than with the histology. Using PCR as the gold standard, 4 values (true positive, false positive, false negative and true negative) were obtained (7, 0, 15 and 3), and histology had a sensitivity, specificity, and positive and negative predictive values of .32, 1.00, 1.00 and .17, respectively. There was a correlation between low-risk and high-risk for PCR (chi 2 with Yates correction = 6.32, P = .012).
Conclusion:
PCR is a powerful tool for the early detection of HPV infection and is independent of histologic criteria.