Causative relations between human papilloma virus infection and cervical intraepithelial neoplasia

The aim of this study was to assess the correlation between human papilloma virus (HPV) infections and cervical intraepithelial neoplasia (CIN). The study included 421 women (aged 18 - 45 years) who were examined gynecologicaly; their medical history and Pap smear results were collected and colposcopy and HPV tests were performed. In those cases where colposcopy and cytological evidence of atypism was found, biopsy or abrasion from the uterine cervix was performed. The GenoFlow HPV Array Test Kit was used to analyse the HPV status in cervical samples collected during the study. The obtained results showed that, one/more HPV genotypes were identified in 42% (177/421) and HPV(-) in 58% (244/421) of the examined women. In the HPV(+) group, CIN was diagnosed in 57 (13.5%) women, whereas, in the HPV(-) group, in 44 (10.5%) women. There was a significant dependence between HPV(+) status and development of CIN (p = 0.001), but the statistical analysis did not reveal sufficient positive predictive value or precision (p > 0.05), i.e. probability that (randomly selected) HPV(+) patients have CIN; neither sensitivity (p > 0.05), i.e. probability that (randomly selected) CIN patients are HPV(+); nor specificity (p > 0.05), i.e. probability that (randomly selected) women without CIN are HPV(-). These results indicate that infection with HPV is probably not the only cause for development of CIN.