Role of DNA ploidy in diagnosis and prognosis of high‐grade cervical intraepithelial neoplasia: A prospective cohort study

Abstract

AbstractObjectiveTo compare the sensitivity and specificity of DNA ploidy with cytology, human papillomavirus (HPV) testing and colposcopy in diagnosis of high‐grade cervical intraepithelial neoplasia (CIN) and to assess the role of aneuploidy in cervical lesions with the worst prognosis. A prospective observational cohort study was conducted on 254 women with altered colpocytology.MethodsColposcopy, biopsy, DNA‐ICM and HPV examinations were applied to cervical cytological and histological samples. Participants were evaluated every 6 months and divided into two groups: ‘Harm’ and ‘No‐harm’. Logistic regression and multivariate COX model were used to identify independent risk factors for diagnosis and prognosis of high‐grade CIN, and ROC curve to assess the sensitivity and specificity of methods.ResultsVariables ‘age greater than or equal to 30 years’, ‘lesion size greater than 20%’, ‘aneuploidy’ and ‘HPV 16’ were associated with diagnosis of high‐grade CIN and ‘aneuploidy’ and ‘women living with HIV’, with a worse prognosis. Agreement for colposcopy was good, with a sensitivity of 79.3% and specificity of 94.4%; DNA‐ICM and cytology were moderate, with sensitivity of 74.6% and 72.3% and specificity of 85.3% and 76.1%, respectively. High‐risk HPV and HPV 16 tests were weak, with sensitivity of 75.0% and 43.75% and specificity of 50.0% and 88.64%, respectively.ConclusionsIn relation to high‐grade CIN diagnosis, DNA‐ICM presented similar sensitivity and specificity to cytology and high‐risk HPV test when associated with HPV 16. Regarding prognosis, this research certifies that aneuploidy is considered a predictor of more severe cervical injury.