No confirmed case of human papillomavirus DNA-negative cervical intraepithelial neoplasia grade 3 or invasive primary cancer of the uterine cervix among 511 patients

Am J Obstet Gynecol. 2003 Jul;189(1):118-20. doi: 10.1067/mob.2003.439.


Objective: This study was undertaken to analyze the prevalence and peculiarities of high-grade cervical neoplasias that are not associated with human papillomavirus (HPV) DNA.

Study design: Four hundred nineteen women with a first-time diagnosis of cervical intraepithelial neoplasia grade 3 and 92 women with cervical cancer were examined prospectively with a commercially available HPV DNA test. Negative samples were re-tested by polymerase chain reaction (PCR) with general and type-specific primers while the corresponding histology specimens were evaluated by immunohistochemistry.

Results: Of the 511 cases examined, 14 were HPV DNA negative on initial analysis. Of these, 7 were found not to be high-grade cervical neoplasia on histologic review, 3 cases were found to contain high-risk HPV types by PCR, and 2 samples were found to be inadequate for analysis. The 2 remaining HPV-negative cases were FIGO stage III and IV tumors. Immunohistochemistry was consistent with a primary adenocarcinoma of the ovary in 1 case and a primary bladder tumor in the other, although a primary cancer of the cervix could not be ruled out completely.

Conclusion: After exclusion of inadequate samples and erroneous diagnoses, HPV DNA was associated with all confirmed cervical intraepithelial neoplasia grade 3 and primary cervical cancers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / virology
  • Biopsy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology
  • DNA, Viral / analysis*
  • Female
  • Humans
  • Papillomaviridae / genetics*
  • Polymerase Chain Reaction
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / virology*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / virology*


  • DNA, Viral