RESUMEN
Prescription of an HPV test in practice will enable the clinician to optimize the monitoring and the management of patients, especially in the context of cervical cancer screening. Numerous HPV tests are available that present different analytical and clinical sensitivity and specificity. International recommendations on clinical performance of HPV tests used for cervical cancer screening have been published by a group of experts, and tests that meet these performance criteria should be used. Apart from the HPV detection kit, the whole circuit from sampling to report of the results must be considered. This implies that the pre-analytical (sampling, quality of sample collection medium, storage condition and sample transportation ) and post-analytical steps (quality of result reporting, providing expert advices ) are also standardized. For this purpose, medical-biology laboratories are subjected to a COFRAC certification, as defined by the international standard ISO 15189 providing quality criteria for any clinical laboratory test and HPV test in particular.
Asunto(s)
Sondas de ADN de HPV/normas , Infecciones por Papillomavirus/diagnóstico , Manejo de Especímenes/normas , Femenino , HumanosRESUMEN
El papilomavirus humano (HPV) ha sido implicado como el agente causal del condiloma acuminado y de carcinomas anogenitales. Los papilomaviruses son pequeños virus tumorales compuestos por DNA que infectan células epiteliales e inducen lesiones proliferativas. Muchos datos epidemiológicos en conjunto con estudios in vitro e in vivo han implicado los HPV en el desarrollo de enfermedades malignas epiteliales. Más del 90 por ciento de todos los carcinomas cervicales son positivos para la infección por HPV. la mayoría de estas lesiones son ocacionales por tipos del HPV de alto riesgo. En esta revisión se analizan las propiedades biológicas básicas del HPV y lo que se comprende hasta ahora de los mecanismos de transformación celular, También los mecanismos del HPV asociados a la carcinogénesis en los huéspedes normales e inmunocomprometidos.
Asunto(s)
Humanos , Sondas de ADN de HPV , Sondas de ADN de HPV/inmunología , Sondas de ADN de HPV/normas , Papiloma/diagnóstico , Papiloma/fisiopatologíaRESUMEN
In situ hybridization is commonly used for the detection of human papillomavirus (HPV) DNA in genital tract lesions. Systems based on biotin complexes are quicker and easier to use than 35S-based systems, although reportedly less sensitive. We compared three in situ hybridization systems for HPV DNA detection: two biotin [PathoGene DNA probe assay [Enzo Diagnostics] and Viratype in situ HPV probes and HPV tissue hybridization kit [Life Technologies Inc. (LTI)] and one 35S based. By using serial sections from 80 female genital tract lesions with the histologic features of an HPV infection, sequences homologous to HPV DNA were detected in 59 cases (74%) with the LTI system and 25 cases (31%) with the Enzo system. The Enzo system uses a streptavidinbiotinylated horseradish peroxidase complex and 2% 3-amino-9-ethylcarbazole as the chromogen. The LTI system uses a streptavidin alkaline phosphatase conjugate in which the chromogen is 5-bromo-4-chloro-3-indolylphosphate in the presence of nitroblue tetrazolium. Replacing the Enzo detection system with the LTI detection system increased the sensitivity of the Enzo kit. The LTI biotin system was equally sensitive when compared against 35S-labeled HPV probes. The sensitivity with the biotin probes, reported to be less than the 35S probes in a previous study (Lab Invest 58:354, 1988), was increased if the current LTI detection system replaced the detection system used in that study. It is concluded that biotin-labeled DNA probes can be equally sensitive to 35S-labeled DNA probes for the detection of sequences homologous to HPV DNA. The enhanced sensitivity for the biotin system is primarily due to improved detection of the probe/target complex.