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Evaluation of HPV-DNA Test in Detection of Precancerous and Cancerous Lesions of Cervix.

Nahid Yusuf, M Ahmed Ali, Md Latifur Rahman, Hasina Akther, Jahan Ara Khanam, and Md Nazrul Islam Mondal

The knowledge that cervical neoplasia are caused by Human Papillomavirus (HPV) infection has led to the evaluation of its role in screening of cervical neoplasia. This study was carried out to evaluate the accuracy of HPV-DNA test in diagnosis of precancerous and cancerous lesions of cervix in relation to histopathology. Total no of 115 eligible women were included in this study. After recording relevant data cervix was examined on naked eye by cuscos speculum. Paps smear collection and VIA tests were done concurrently. Colposcopic examination was done who were positive in screening tests. In addition, subjects with grossly abnormal cervix even with negative in screening tests were also referred for colposcopy. Samples for HPV DNA were taken from the patients referred for colposcopy and biopsies were done in the same patients. Those with CIN I or worse lesions diagnosed by histology were considered as true positive. The study results showed the test parameters for VIA were sensitivity of 94.11%, specificity of 57.57%, positive predictive value of 12.20%, and negative predictive value of 99.70%. The test parameters for Pap smear were sensitivity of 64.71%, specificity of 94.29%, positive predictive value of 51.70% and negative predictive value of 99.80%. The test parameters for HPV DNA test were sensitivity of 82.35% and specificity of 84.85%, positive predictive value of 73.68% and negative predictive value of 90.32%. VIA and HPV-DNA tests detected all cases of high grade lesions (CIN II & III) and carcinoma. This study was that VIA is superior to Pap smear cytology and HPV-DNA test in sensitivity, that is VIA can more accurately identify the CIN/ cancer patients, On the other and Pap smear is superior to VIA and HPV-DNA test in specificity that it can more accurately identify the truly well people and HPV-DNA has strong association in high grade lesions of the cervix.