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Journal of Clinical Microbiology, October 2008, p. 3215-3221, Vol. 46, No. 10
0095-1137/08/$08.00+0     doi:10.1128/JCM.00476-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Comparison of GP5+/6+-PCR and SPF10-Line Blot Assays for Detection of High-Risk Human Papillomavirus in Samples from Women with Normal Cytology Results Who Develop Grade 3 Cervical Intraepithelial Neoplasia{triangledown}

A. T. Hesselink,1 M. A. P. C. van Ham,2 D. A. M. Heideman,1 Z. M. A. Groothuismink,1 L. Rozendaal,1 J. Berkhof,3 F. J. van Kemenade,1 L. A. F. G. Massuger,2 W. J. G. Melchers,4 C. J. L. M. Meijer,1 and P. J. F. Snijders1*

Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands,1 Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands,2 Department of Biostatistics and Epidemiology, VU University Medical Center, Amsterdam, The Netherlands,3 Department of Medical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands4

Received 11 March 2008/ Accepted 25 July 2008

Using a case control approach, we performed a two-way comparison study between GP5+/6+-PCR and HPV SPF10-Line Blot 25 (SPF10) assays for detection of 14 types of high-risk human papillomavirus (hrHPV) in samples from women with normal cytology results who had or developed grade 3 cervical intraepithelial neoplasia (CIN 3). Samples were pooled from two cohorts, i.e., women participating in population-based screening and women attending a gynecological outpatient clinic. Cases (n = 45) were women with histologically confirmed CIN 3 diagnosed within a median follow-up time of 2.7 (range, 0.2 to 7.9) years. Control samples were from women (n = 264) who had developed CIN 1 lesions at maximum (median follow-up at 5.8 [range, 0 to 10] years). Identical numbers of cases tested positive for 1 or more of the 14 hrHPV types by both systems (40/45; McNemar; P = 1.0). Conversely, SPF10 scored significantly more controls as hrHPV positive than did GP5+/6+-PCR (95/264 versus 29/264; McNemar; P < 0.001). Consequently, women with normal cytology results and an hrHPV GP5+/6+-PCR-positive test exhibited a risk of CIN 3 that was 4.5 times higher (odds ratio [OR], 65; 95% confidence interval [95%CI], 24 to 178) than that seen for women with an hrHPV-positive SPF10 test (OR, 14; 95%CI, 5 to 38)). Similar results were obtained after analysis of both cohorts separately. Discrepancy analysis by viral load assessment for the most common discordant hrHPV types (HPV16, -18, and -52) showed that samples which were SPF10 positive only for these types had viral loads significantly lower than those for samples that were positive by both assays (analysis of variance; P ≤ 0.006). Our data indicate that GP5+/6+-PCR has a better clinical performance than SPF10 for women who are diagnosed with CIN 3 after prior normal cytology results. The extra positivity scored by SPF10 mainly involved infections characterized by low viral loads that do not result in CIN 3.

* Corresponding author. Mailing address: Department of Pathology, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Phone: 31-20-4444023. Fax: 31-20-4442964. E-mail: pjf.snijders{at}vumc.nl

{triangledown} Published ahead of print on 6 August 2008.

Journal of Clinical Microbiology, October 2008, p. 3215-3221, Vol. 46, No. 10
0095-1137/08/$08.00+0     doi:10.1128/JCM.00476-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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