Document Detail


Comparative evaluation of smear cytology & hybrid capture II for the diagnosis of cervical cancer.
MedLine Citation:
PMID:  17890822     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND & OBJECTIVES: There is no ideal screening method for cervical cancer in India with the role of human papilloma virus (HPV) detection yet to be established. This study was undertaken to compare the diagnostic accuracy of HPV testing by hybrid capture II (HC-II) with conventional cervical smear cytology for squamous intraepithelial lesions (SIL).
METHODS: This prospective study was conducted at New Delhi during 2003-2004 with patients selected from the gynaecology out patients of the All India Institute of Medical Sciences. Initial screening by a questionnaire and per-speculum examination were used to select high-risk patients. Patients, in whom conventional cytology, HC-II test and colposcopy-directed biopsy were done, formed the basis of this study.
RESULTS: Of the 133 patients included in the study, incidence on biopsy of low grade SIL (L-SIL) was 6.77 per cent, high grade SIL (H-SIL) was 8.27 per cent and carcinoma was 3.00 per cent. Sensitivity and specificity of cytology for detection of H-SIL and above lesions was 93.33 and 83.49 per cent while for HC-II it was 93.33 and 90.83 per cent, respectively. HC-II had higher diagnostic accuracy of 91.13 per cent versus 84.68 per cent for cytology. Kappa for HC-II was higher (0.67) than cytology (0.52). Among patients diagnosed to have atypical squamous cells (ASC-US & ASC-H) and L-SIL, HC-II helped to select patients who had significant lesions on biopsy.
INTERPRETATION & CONCLUSION: The main utility of HC-II is in the triage of patients with cytology smear diagnosis of ASC-US, ASC-H or L-SIL, for referral to colposcopic examination. HC-II alone has the best diagnostic accuracy but owing to high cost it is unsuitable for general screening in developing countries. Combining HC-II with cytology will refer smaller numbers for colposcopy,improving efficient utilization of available resources.
Authors:
Kamlesh Kumar; Venkateswaran K Iyer; Neerja Bhatla; Alka Kriplani; Kusum Verma
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Indian journal of medical research     Volume:  126     ISSN:  0971-5916     ISO Abbreviation:  Indian J. Med. Res.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-09-24     Completed Date:  2007-10-30     Revised Date:  2013-04-18    
Medline Journal Info:
Nlm Unique ID:  0374701     Medline TA:  Indian J Med Res     Country:  India    
Other Details:
Languages:  eng     Pagination:  39-44     Citation Subset:  IM    
Affiliation:
Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India.
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MeSH Terms
Descriptor/Qualifier:
Colposcopy
Cytodiagnosis
Female
Humans
Papillomaviridae / isolation & purification*
Prospective Studies
Uterine Cervical Neoplasms / diagnosis*,  virology
Vaginal Smears*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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