Detection of human papilloma virus in women referred for colposcopy. A comparison between different diagnostic methods.

Various methods presently available for the diagnosis of genital Human Papilloma Virus (HPV) were compared regarding their sensitivity in women referred for specific diagnosis and treatment because of atypical Pap smears or clinically suspected neoplasia. Colposcopic examination was performed in all cases. In addition to taking a second Pap smear, cell suspensions were made from 105 women and analysed by the Filter In Situ Hybridization (FISH) technique and tested for HPV 6 + 11 and HPV 16 + 18 + 31. The FISH technique was also used for the possible detection of HPV-DNA in a reference material comprising 119 apparently healthy women with normal Pap smears. Colposcopically directed cervical biopsies in altogether 196 specimens were obtained from 155 women for histopathological examination and also for the detection of HPV-DNA by the Southern blot hybridization technique. These specimens were tested for the presence of HPV 6, 11, 16, 18, 31 and 33. Three per cent of the women with and 34% without cytological signs of HPV in Pap smears had cervical intraepithelial neoplasia (CIN) III according to histopatology. CIN III was present in 35% of biopsies with and 59% of biopsies without histological signs of HPV in the biopsies. Altogether 46% of the women were HPV-DNA positive. Of the women analysed by Southern blot, 39% were HPV-DNA positive. Of the samples analysed by FISH, 27% with atypical cells were HPV-DNA positive, compared with 11% of the samples from reference women with normal cytology.(ABSTRACT TRUNCATED AT 250 WORDS)