Comparative study of human papilloma virus DNA detection and results of histopathological examination of cervical colposcopic biopsy

Background: There is mounting evidence for HPV involvement in cervical cancer Human Papilloma Virus DNA is detected by hybridization techniques in 75 - 100% of patients with condylomas, precancerous cervical dysplasia, and invasive carcinoma. Objective: The aim of this study was investigating factors that may contribute to false-negative colposcopic biopsy results in positive high-risk HPV DNA results. Material and Methods: Patients positive for high-risk human papillomavirus (HPV) DNA with negative cervical histopathologic findings were examined between January 2004 and August 2006. Results: Patients with atypical squamous cells of undetermined significance (ASC) in Papanicolaou smears, with positive HPV DNA results, but negative cervical histopathologic findings accounted for 4.5% of all ASC smears submitted for HPV DNA testing. We found 4% of the cases had focal HPV infection or mild dysplasia. When serial sectioning of the biopsy material were examined, we found that 29% had clinically significant lesions: HPV infection or cervical intraepithelial neoplasia CIN 1, 18%; CIN II/III, 8%; and dysplasia, not otherwise specified (which we can not categorize into any group), 3%. Of the remaining patients, follow-up revealed squamous abnormalities in 25%. About 5% of patients with positive HPV DNA results had a negative follow-up biopsy result. "False-negative" biopsies accounted for one third of cases. Conclusion: In almost one third of cases, clinically significant lesions were found when additional levels were examined.