Diagnostic Value of Cytology Testing, High-risk HPV DNA Typing and Aptima HPV Assay based on Cervical Biopsy for Cervical Cancer and Neoplasia Diagnosis

Cytology testing has been successful in reducing the incidence of cervical cancer and mortality. Molecular testing like HPV typing and Aptima test can improve screening effectiveness. We compared the diagnostic value of cytology testing, High-risk (HR) HPV DNA typing, and APTIMA tests based on the results of the cervical biopsy in the diagnosis of cervical cancer and neoplasia in patients referred to Imam Khomeini Hospital.

One hundred fifty women between 21 and 56 years old who referred to having clinical symptoms or conducting screening tests enrolled in the study. Sensitivity, specificity, positive and negative predictive values, and accuracy for cervical involvement were calculated for cytology, High-risk HPV testing, and APTIMA tests separately.

The most abundant genotype found was HPV 16. cytology testing had a sensitivity of 59% for CIN 2+ and a specificity of 61% for CIN 2+. For CIN I, the sensitivity and specificity of cytology testing were higher (63% and 71%, respectively). High-risk HPV typing had the highest sensitivity (76%) for CIN 2+, but its specificity was low (66%). Its sensitivity was 51% for CIN I with a specificity of 74%. APTIMA tests had a sensitivity of 53.7% and a specificity of 87.5% for CIN2 +, which was less sensitive to High-risk HPV typing but was more specific. The APTIMA test sensitivity for CIN I was very low (22.2%), but its specificity was high (87.5%).

High-risk HPV typing showed the highest sensitivity (75.9%) and APTIMA tests had the highest specificity (87.5%) in predicting CIN 2+.