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Genotype profile of HPV in ASC-H cytology and histologic follow-up-prevalence, distribution, and risk: A retrospective study of 1414 cases.
Sun, Yihua; Wang, Tiannan; Zhong, Fangfang; Starr, David; Zeng, Xianxu; Zhang, Hao; Xiao, Jianan; Zhou, Xianrong; Tao, Xiang; Zhao, Chengquan.
Afiliación
  • Sun Y; Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
  • Wang T; Department of Pathology, University of Southern California, Los Angeles, California, USA.
  • Zhong F; Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
  • Starr D; Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Zeng X; Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
  • Zhang H; Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
  • Xiao J; Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
  • Zhou X; Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
  • Tao X; Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
  • Zhao C; Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Cancer Cytopathol ; 2024 Jun 16.
Article en En | MEDLINE | ID: mdl-38879864
ABSTRACT

BACKGROUND:

A cytologic diagnosis of atypical squamous cells, cannot exclude high-grade squamous lesion (ASC-H) poses a disproportionately high risk of cervical cancer development. The objective of this study was to analyze type-specific risks by mapping human papillomavirus (HPV) genotypes in ASC-H cytology.

METHODS:

In total, 1,048,581 Papanicolaou tests that had ASC-H cytology were retrieved. Concurrent HPV genotyping using proprietary multiplex real-time (MRT) and polymerase chain reaction (PCR) HPV tests and histologic follow-up findings were analyzed.

RESULTS:

Among 1678 patients who had ASC-H findings (0.16%), 1414 (84.3%) underwent concurrent HPV genotyping (MRT, 857; HPV PCR test, 557). The overall high-risk HPV (hrHPV)-positive rate was 84.4%. Of the 857 MRT cases, 63.9% were infected with a single hrHPV, and 24.4% had multiple genotypes. The most prevalent HPV types were HPV16/52/58/33/31. Lesions that were identified as cervical intraepithelial neoplasia 2 or worse (CIN2+) were detected in 498 of 906 cases (55.0%), including 81 cervical carcinomas (8.9%). The risk of CIN2+ for the composite group of HPV16/52/58/33/31-positive cases was 62.7%, representing 90.7% (264 of 291) of total CIN2+ lesions in ASC-H/hrHPV-positive cases by MRT. CIN2+ lesions were detected in 108 of 142 (76.1%) HPV16-positive and/or HPV18-positive women by the PCR the HPV test. Among 128 hrHPV-negative ASC-H cases by both methods, CIN2+ lesions were identified in 21 of 128 (16.4%), including five cervical carcinomas (3.9%). The sensitivity, specificity, positive predictive value, and negative predictive value for patients in the composite group with HPV16/52/58/33/31 were 88.0%, 40.8%, 62.7%, and 75.0%, respectively.

CONCLUSIONS:

Papanicolaou tests classified as ASC-H are associated with a high CIN2+ rate and warrant colposcopy, regardless of HPV status. The extent to which the risk-stratification provided by comprehensive HPV genotyping can inform the management of ASC-H cytology remains to be explored.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cancer Cytopathol Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Cancer Cytopathol Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos