Objective: To explore the clinical significance of detection of multiple human papillomavirus infection in cervical lesions detected by flow fluorescent hybridization technology with Luminex multi-analytic profiling (xMAP).
Methods: Cervical exfoliated cell specimens were collected from 301 randomly selected women accepting opportunistic screening for cervical lesions with the cytological results and hybrid capture 2 (HC-2) assay>or=atypical squamous cells of uncertain significance (ASC-US), 48 with the pathological diagnosis>or=cervical intraepithelial neoplasia (CIN)2 (case group) and 253 with normal histological result or only inflammation (control group), aged (34+/-9) (21-59). The samples were tested with xMAP technology with blind method. The coincidence of the xMAP and HC-2 was assessed. The HPV genotype, multiple HPV infection rate, and their relationships to the patients' clinical-pathological features were analyzed.
Results: The rates of sensitivity, specificity, and accuracy of xMAP technology to detect>or=CIN2 cervical lesions were 80.49%, 80.00%, and 80.07% respectively. The positive and negative predictive values were 47.06% and 96.30% respectively. The Kappa Index for agreement between xMAP technology and HC-2 was 0.56. The prevalence rate of high-risk HPV infection was 28.24% (85/301). The prevalence rate of multiple HPV infection was 11.30% (34/301), significantly lower than that of single type high-risk HPV infection (16.94%, P<0.05). The proportion of multiple HPV infection in total positive HPV results was 35.05% (34/97). The proportion of duplex and treble HPV infection were 29.90% (29/97) and 5.15% (5/97) respectively. The multiple HPV infection rate of the case group was 37.50% (18/48), significantly higher than that of the control group (6.32%, 16/253, P<0.01). The common duplex HPV infection modes were 16+51/58 (n=4), 51/58+52/59 (n=4), 11+16 (n=3), and 11+52/59 (n=3), 18+52/59 (n=3). The common treble HPV infection modes were 11+16+52/59, 16+18+31, 16+18+52/59, 31+33+39, and 31+33+52/59 (all n=1). HPV16, 52/59, 51/58, 18, 11, and 31 were the common types in multiple HPV infections.
Conclusion: Flow fluorescent hybridization technology is able to detect multiple HPV infection that is associated with cervical lesions and to identify the HPV genotypes.