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Korean Journal of Obstetrics & Gynecology 2005;48(12):2888-2895.
Published online December 1, 2005.
The association of the cervical intraepithelial neoplasia and human papillomavirus viral load.
Jae Sun Park, Hee Sug Ryu, Suk Jun Chang, Yong Mi Kim, Ki Hong Chang, Jung Pil Lee
Department of Obstetrics and Gynecology, Ajou University College of Medicine, Suwon, Korea. hsryu@ajou.ac.kr
Abstract
OBJECTIVE
The purpose of this study was to determine the relationship between the cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) DNA load and to evaluate the efficacy of viral load in prediction of histologic severity. METHODS: The cervical cytology and Hybrid Capture II tests for HPV detection were performed in 2411 women visited our hospital, from August 2003 to October 2004. A total of 259 consecutive women underwent cervical colposcopy directed biopsy and operations with confirmed final histologic diagnoses were included. Viral load was measured by Hybrid Capture II system expressed as relative lights unit (RLU) ratio of specimens and controls. RESULTS: There was no significant difference of CIN 1, CIN 2, CIN 3, SCC group and control group in the clinical characteristics. The higher the viral load, the higher stage of CIN was shown. HPV viral load test showed sensitivity of 82.9%, specificity of 37.7%, positive predictability of 60.0%, negative predictability of 66.2% in detecting CIN, while 94.4%, 34.3%, 67.5%, 80.8% in detecting HGSIL. The viral loads were categorized into four groups (negative, low, intermediate, high) for analysis and it was shown that higher viral load group tended to exist CIN more frequently (odds ratio=1, 1.8, 3.4, 3.5). In addition, viral load was more strongly associated with the risk of HGSIL than that of LGSIL (odds ratio=1, 6.7, 9.0, 9.6). CONCLUSION: We found that the higher HPV viral load is significantly associated with the higher stage of CIN. The measurement of HPV DNA load is useful for predicting the severity of lesions of the uterine cervix and making decision of treatment plans.
Key Words: Papanicolaou smear, Human papillomavirus (HPV), Viral load, Cervical intraepithelial neoplasia (CIN)


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