Atypical squamous cells of undetermined significance cervical cytology in the Chinese population: Age‐stratified reporting rates, high‐risk HPV testing, and immediate histologic correlation results

2020 ◽  
Vol 129 (1) ◽  
pp. 24-32
Author(s):  
Xiang Tao ◽  
Huina Zhang ◽  
Li Wang ◽  
Qiuzhi Pan ◽  
Shuting Ji ◽  
...  
Keyword(s):  
High Risk ◽  
Chinese Population ◽  
Cervical Cytology ◽  
Hpv Testing ◽  
Squamous Cells ◽  
High Risk Hpv ◽  
Reporting Rates ◽  
Undetermined Significance

Is the Human Papillomavirus Test in Combination With the Papanicolaou Test Useful for Management of Patients With Diagnoses of Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesions?

2001 ◽  
Vol 125 (11) ◽  
pp. 1453-1457
Author(s):  
Nak-Woo Lee ◽  
Daesu Kim ◽  
Jong-Tae Park ◽  
Aeree Kim
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Screening Method ◽  
Screening Tests ◽  
Low Grade ◽  
Pap Tests ◽  
Squamous Cells ◽  
Hpv Test ◽  
High Risk Hpv ◽  
Undetermined Significance

Abstract Objective.—To determine whether human papillomavirus (HPV) testing is useful in the evaluation of patients diagnosed with atypical squamous cells of undetermined significance (ASCUS)/low-grade squamous intraepithelial lesion (LSIL) and whether the HPV test is appropriate as an alternative screening method. Design.—The results of Papanicolaou (Pap) tests and subsequent hybrid capture tube (HCT) II tests for high-risk–type HPV were analyzed for 457 patients. Among these tests, 208 histologic diagnoses were made and correlated with the results of Pap and HPV tests. The sensitivity and specificity of the Pap test, HPV test, and the combined method of Pap and HPV tests to detect cervical intraepithelial neoplasia (CIN) 2/3 and all CIN were also measured. Results.—Sixty (63.8%) of 94 women with LSIL and 31 (26.3%) of 118 women with ASCUS tested positive for high-risk HPV. The sensitivity values for Pap tests in detecting all cases of CIN and CIN 2/3 were 91.4% and 92.9%, respectively. The sensitivity values of HCT II tests using the high-risk probe for detecting all cases of CIN and CIN 2/3 were 62.6% and 88.1%, respectively. Biopsies confirmed that 10 (22.7%) of 44 LSIL patients with high-risk HPV had CIN 2/3, but only 1 (4.5%) of 22 LSIL patients without high-risk HPV had CIN 2/3. Conclusion.—Testing for high-risk HPV with the HCT II test is useful in the detection of CIN 2/3 in LSIL groups and in the selection of patients for colposcopy in ASCUS groups, but it is not suitable for cervical cancer screening tests.

Accuracy of high-risk HPV testing compared with cervical cytology in postmenopausal women

2020 ◽  
Vol 159 ◽  
pp. 178
Author(s):  
J.M. Kiff ◽  
M. Cotter ◽  
T.K. Morgan ◽  
A.S. Bruegl
Keyword(s):  
High Risk ◽  
Postmenopausal Women ◽  
Cervical Cytology ◽  
Hpv Testing ◽  
High Risk Hpv

The effectiveness of human papillomavirus load, reflected by cycle threshold values, for the triage of HPV-positive self-samples in cervical cancer screening

2020 ◽  
pp. 096914132094363
Author(s):  
Fangbin Song ◽  
Hui Du ◽  
Chun Wang ◽  
Xia Huang ◽  
Xinfeng Qu ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Intraepithelial Neoplasia ◽  
Threshold Value ◽  
Hpv Testing ◽  
Cervical Lesions ◽  
Squamous Cells ◽  
Cycle Threshold ◽  
Viral Loads ◽  
High Risk Hpv

Objective The performance of Cobas4800 cycle threshold value (Ct-value, reflecting viral load) combined with human papillomavirus (HPV) 16/18 genotyping was explored as a method of risk stratification to triage patients after primary HPV screening of self-collected samples. Methods The Chinese Multi-site Screening Trial database was reviewed, with focus on self-collected samples, using the results of Cobas4800 HPV assay. Quartiles of Ct-values of each genotype were used for grouping and developing screening algorithms. Diagnostic accuracy for paired comparisons between algorithms was obtained using McNemar’s test. Results A total of 10,498 women were included. The Ct-values of HPV16 and other high-risk HPV were inversely correlated with the severity of cervical lesions ( p < 0.001). Risks for cervical intraepithelial neoplasia (CIN2+/CIN3+) were significantly stratified by Ct-values from channels detecting HPV16 and other high-risk HPV types. “HPV with HPV16/18 and reflex Ct <33.7” (algorithm G) achieved a favorable sensitivity to “HPV with atypical squamous cells of undetermined significance or worse (≥ASCUS)” (81.9% vs. 70.1% for CIN2+, p < 0.001), a comparable sensitivity to “HPV with HPV16/18 reflex cytology ≥ASCUS” (81.9% vs. 81.3% for CIN2+, p > 0.05), and resulted in a slightly lower specificity than the latter two algorithms (92.6% vs. 97.4% and 95.4% respectively for CIN2+, p < 0.05). However, algorithm G achieved a comparable sensitivity to HPV testing alone for CIN3+, and reduced the colposcopy referral rate from 13.7% for HPV testing alone to 8.4%. Conclusions HPV viral loads reflected by Ct-values are associated with the severity of cervical lesions. Ct-values with an appropriate cut-off of 33.7, combined with HPV16/18 genotyping, represent a promising triage of HPV-positive women particularly for self-collected samples.

Colposcopy referral rate can be reduced by high-risk human papillomavirus triage in the management of recurrent atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion cytology in Finland

2012 ◽  
Vol 23 (7) ◽  
pp. 485-489 ◽  
Author(s):  
M Jakobsson ◽  
J Tarkkanen ◽  
E Auvinen ◽  
R Häkkinen ◽  
P Laurila ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Study Groups ◽  
Referral Rate ◽  
Cervical Cytology ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Undetermined Significance

The aim of this study was to establish whether a combination of high-risk human papillomavirus (hrHPV) testing and cervical cytology could reduce colposcopy referral among women with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion cytology. We randomized 598 women in the Helsinki area, Finland into three study groups. Different strategies of hrHPV testing, cytology and colposcopy with biopsy were used; subsequent hrHPV test results and cytological findings were compared with histology. The rates of hrHPV positivity and CIN2+ were compared. In total, 62.5% of all samples were hrHPV-positive. Altogether 45 (12.7%) CIN2 or worse (CIN2+) lesions were found in study groups A and B. Among hrHPV-positive women the rate of CIN2+ was 19.0% ( n = 43), in contrast with 1.6% ( n = 2) among hrHPV-negative women (relative risk = 12.2, 95% confidence interval [CI] 3.6–81.1, P < 0.001). Among all hrHPV-negative women whose cytological findings were normal or ASCUS, dysplastic lesions were uncommon ( n = 4/119, 3.4%), and all were CIN1. If these women had not been referred to colposcopy, the number of colposcopies would have been reduced by 33.6%. We conclude that hrHPV testing combined with repeat cervical cytology had a high negative predictive value in patients with recurrent low-grade cervical cytology. This could reduce the referral rate to colposcopy without jeopardizing patient safety.

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