Resumen

ISAZA-RUGET, Mario Arturo et al. The accuracy of the HPV-DNA test for detecting high grade disease (CIN2+) in women with minor cytological abnormalities (ASC-US and LSIL) in patients affiliated to the social security system in Bogota, Colombia. Rev Colomb Obstet Ginecol [online]. 2009, vol.60, n.3, pp.213-222. ISSN 0034-7434.

Objective: evaluating the accuracy of the HPV DNA test as a complementary test for diagnosing highgrade cervical disease (high-grade squamous intra epithelia lesions-HSIL) in women with minor cytological abnormalities (atypical squamous cells of undetermined significance ASC-US) and low-grade squamous intraepithelial lesions (LSIL). Methodology: a diagnostic validity study based on a cross-sectional design was applied to 429 women who had had a cytological report of ASC-US and/or LSIL who were attending a health maintenance organisation’s cervical cancer screening programme in Bogotá, Colombia between January 2006 and October 2008. Colposcopy reports and HPV-DNA testresultswerecomparedwithpathologicalreports which were considered the gold standard. Results: 344 (80.2%) of the 429 women had a cytological report of ASC-US and 85 (19.8%) of them one for LSIL. High-risk HPV infection prevalence was 52.9% and 75.7% in patients having an ASC-US and LSIL report, respectively. A biopsy specimen was obtained in 379 of the 429 participants and 24 high-grade cases (6.3%) were diagnosed. DNA-HPV test sensitivity was 88% and specificity was 44% for detecting high-grade disease (CIN 2+) in women having an ASC-US and LSIL cytology report . The presence of high-risk HPV virus was detected in 21 of the 24 HSIL cases (87.5%). Conclusion: the DNA-HPV test’s higher sensitivity compared to the PAP smear (due to high NPV) means that it could be considered a useful tool for stratifying risk and improving the diagnostic approach to premalignant lesions of the uterine cervix in patients having a cytological report of ASC-US.

Palabras clave : DNA probe; HPV; papillomavirus infection; cervical intraepithelial neoplasia; cytology; colposcopy.

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