Naslov
Limitation of HPV Testing

Autori
Glavaš-Obrovac, Ljubica

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstract Book of the International Workshop on Human Papillomaviruses and Consensus Recommendations for Cervical Cancer Prevention & Colposcopy Training / Grce, Magdalena - Dubrovnik : Cavtat : Institut Ruđer Bošković, 2007

ISBN
978-953-6690-65-7

Skup
International Workshop on Human Papillomaviruses and Consensus Recommendations for Cervical Cancer Prevention & Colposcopy Training

Mjesto i datum
Cavtat, Hrvatska; Dubrovnik, Hrvatska, 18.04.2007. - 21.04.2007

Vrsta sudjelovanja
Pozvano predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
HPV testing; limitations of molecular methods

Sažetak
Cervical cytology is currently regularly used primary screening test for cervical cancer detection. Sensitivity of this method is in close connection with quality of collected samples and identifying the cell changes is highly subjective which can further lead to interpretive errors1-3. Numbers of clinical and scientific studies have shown that HPV testing is more sensitive than cytology at detecting cervical intraepithelial neoplasia (CIN)2, 3-5. Currently, there are two HPV DNA methods, the hybrid capture second-generation (HC2) and polymerase chain reaction (PCR)-based tests, in widespread clinical use7-10. Although these tests are very sensitive and high reproducible each of them has specific limitations. Thus, the HC2 test detects mainly high-risk HPV genotypes and does not allow a distinction between different HPV genotypes. The main fault of this test is cross-reactions with low-risk types which can cause false positive results and may decrease the specificity of the test4, 12, 13. The main drawback of PCR-based methods is variability in sensitivity and specificity which depends on sampling methods, DNA extraction procedures, primer sets, reaction conditions and performance of the DNA polymerase used in the reaction, the spectrum of HPV DNA amplified, and ability to detect multiple types7, 8, 14, 15. It should be noted that validated protocols, reagents, reference samples, and adaptation of the HPV type panel to geographically different HPV type prevalence might improve the specificity of the PCR based methods. Each of aforementioned screening techniques is suitable for detection of HPV in female genital specimens, notably cervical smears, however neither is recommended for use in men. Detection of genital HPV in men is technically more complicated than in women partially due to lack of definition with regard to which sites should be tested and how these sites should be sampled16-18. Initially, peniscopy with a colposcope of acetic-acid treated skin appeared to improve the clinical diagnostic accuracy in men. Problems associated with these techniques include insufficient collection of cells for detection of HPV DNA by use of swabs and brushes, false-positive results secondary to nonspecific penile aceto-whitening that infrequently reveals abnormal histological findings, poor specificity with peniscopy, and discomfort among patients during peniscopy with biopsy19-22. Brushed material collected from the distal urethra and from the external surface of the penis seems to be the optimal sampling method for diagnosing HPV infection in men23. Regarding the all advantages that HPV testing offers the user must be aware of its limitations.

Izvorni jezik
Engleski

Znanstvena područja
Kemija, Biologija, Temeljne medicinske znanosti

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