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K J McKinnon

Publications and source records attributed to K J McKinnon.

7 recordsLinked to original sources
PubMed1993

Comparison of cytology and cervicography in screening a high risk Australian population for cervical human papillomavirus and cervical intraepithelial neoplasia.

Two different screening methods, the Papanicolaou (Pap) smear and cervigram were compared in screening 245 Sydney women over a 6-month period in 1988 at a city sexually transmitted diseases (STD) centre, for cervical human papillomavirus (HPV), cervical intraepithelial neoplasia (CIN) and cervical cancer. The Pap smear through the identification of cytologically abnormal cells correctly detected 54% of cases of histologically proven CIN and 39.2% of cases of HPV. The cervigram through the identification of acetowhite epithelium and/or abnormal vessels on the cervix correctly detected 64% of cases of histologically proven CIN and 70.6% of cases of HPV. However, when both tests were used together, 92% of CIN lesions and 82.4% of HPV lesions were correctly identified. Histology of a colposcopically directed biopsy was used as the 'gold standard'. The sensitivity and specificity of the Pap smear after correction for verification bias was 46% and 78% respectively, and for the cervigram was 49% and 60% respectively. Hence neither screening test appears adequate on its own, at least in an STD population.

Adolescent↗
PubMed1990

Automated polymerase chain reaction for papillomavirus screening of cervicovaginal lavages: comparison with dot-blot hybridization in a sexually transmitted diseases clinic population.

The aim of the present study was to compare the recently developed polymerase chain reaction (PCR) technique with conventional dot-blot DNA hybridization for human papillomavirus (HPV) detection. Cells were collected by cervicovaginal lavage from a study group of 109 women attending a sexually transmitted diseases clinic. Using a machine that we developed for alternation of temperature cycles, HPV was detected in 51% of patients by PCR. By dot-blot hybridization, 44% of the patients were positive. Concordance of combined positive and negative results between PCR and dot blot was 69%. The greater sensitivity of PCR may have accounted for 19% of specimens that were PCR positive but dot-blot negative. Unexpectedly, however, 12% of specimens were dot-blot positive but negative by PCR, and several specimens were discordant for type of HPV. Both HPV DNA tests agreed with cytology in 41% of women, and in 33% cytology was negative in the face of positive PCR and dot blot. Concordance of cytology with just PCR was 59%, and only with dot blot was 56%. Cervicography agreed with both HPV DNA tests in 41% of patients, with PCR alone in 55%, and with dot blot alone in 58%. Biopsy results did not reveal a strong correlation between histopathological criteria of HPV infection and detection of HPV DNA by either PCR or dot-blot hybridization. Thus the present study has shown that PCR is a slightly more sensitive indicator of HPV infection than dot-blot hybridization. Agreement of HPV DNA results with conventional screening tests was not strong, an observation consistent with many comparative studies by others. In conclusion, PCR is slightly more sensitive than DNA hybridization for detection of HPV, it can be used in conjunction with specimen collection by gentle lavage of the cervicovaginal epithelium, and the possibility remains that it may prove suitable as a screening test.

Adolescent↗
PubMedDate not supplied

High prevalence of human papillomavirus and cervical intraepithelial neoplasia in a young Australian STD population.

Two hundred and forty-five women consecutively attending a large city Sexually Transmitted Diseases (STD) Centre had routine cervical screening performed by both the Pap smear and, in addition, a Cervigram. The aim of this study was to determine the prevalence of HPV infection, CIN and cervical cancer in an STD population. The mean age of this group was 26 years with a range from 16 to 53 years. Colposcopy and biopsy revealed a prevalence for human papillomavirus (HPV) of 41%, and 20.4% for cervical intraepithelial neoplasia (CIN). No cases of cervical cancer were detected. The Pap smear detected HPV-associated change in 18% and CIN in 8.2%, therefore generally underestimating the true prevalence of HPV and CIN. Cervicography was positive in 44% of the total group, indicating either HPV-associated change or CIN. Current screening methods are therefore failing to detect significant amounts of HPV-associated change and CIN.

Adolescent↗