scholarly journals Evaluation of the In Situ Hybridization Signal Patterns of Liquid-Based Cytological Human Papillomavirus Specimens for Diagnosing Squamous Intraepithelial Lesion

2011 ◽  
Vol 2011 ◽  
pp. 1-9
Author(s):  
Katsunari Ishida ◽  
Makoto Nagasaki ◽  
Masayuki Kobayashi ◽  
Tatsushi Nakagawa ◽  
Toru Nabika ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Routine Testing ◽  
Squamous Cells ◽  
Intraepithelial Lesion ◽  
Liquid Based Cytology ◽  
Undetermined Significance

To examine the diagnostic utility for squamous intraepithelial lesion (SIL) by cytological in situ hybridization (c-ISH) for the human papillomavirus using liquid-based cytology specimens, we investigated c-ISH signal patterns in the cases of low-grade SIL (LSIL), atypical squamous cells of undetermined significance (ASC-US), and high-grade SIL (HSIL). Episomal (E) and/or integrated (I) signals were observed. Two signal patterns (E≧I or I>E) were obtained by counting the number of E+ or I+ cells. E≧I was specific to LSIL and ASC-US (10/12); I>E, to HSIL (9/11) (P<0.01, χ2 test), suggesting significant utility of c-ISH in diagnosing SIL. In the cell fraction, E≧I in large cells was dominant in LSIL. Two cases of I>E in large cells of LSIL showed HPV persistence and/or progression during follow-up. Thus, c-ISH is useful in routine testing for diagnosing cervical dysplastic lesions, especially for detecting LSIL suspected for progression.

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.

scholarly journals Atypical Squamous Cells of Undetermined Significance: Bethesda Classification and Association with Human Papillomavirus

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Ana Cristina Macêdo Barcelos ◽  
Márcia Antoniazi Michelin ◽  
Sheila Jorge Adad ◽  
Eddie Fernando Candido Murta
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Trichomonas Vaginalis ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Hpv Test ◽  
Intraepithelial Lesion ◽  
High Risk Hpv ◽  
Undetermined Significance

Introduction. To analyze patients with atypical squamous cells of undetermined significance (ASCUS) through a cytology review and the presence of microbiological agents, with consideration of colposcopy and semiannual tracking.Methods. 103 women with ASCUS were reviewed and reclassified: normal/inflammatory, ASCUS, low-grade squamous intraepithelial lesion (LSIL), or high-grade squamous intraepithelial lesion (HSIL). If ASCUS confirmed, it was subclassified in reactive or neoplastic ASCUS, ASC-US, or ASC-H; and Regione Emilia Romagna Screening Protocol. Patients underwent a colposcopic examination, and test forCandidasp., bacterial vaginosis,Trichomonas vaginalis, and human papillomavirus (HPV) were performed.Results. Upon review, ASCUS was diagnosis in 70/103 (67.9%), being 38 (54.2%) reactive ASCUS and 32 (45.71%) neoplastic ASCUS; 62 (88.5%) ASC-US and 8 (11.41%) ASC-H. ASCUS (Regione Protocol), respectively 1-5: 15 (21.4%), 19 (27.1%), 3 (27.1%), 16 (22.8%), and 1 (1.4%). A higher number of cases of cervical intraepithelial neoplasia (CIN) II/III in the biopsies of patients with ASC-H compared to ASC-US (P=.0021). High-risk HPV test and presence of CIN II/III are more frequent in ASC-H than ASC-US (P=.031).Conclusions. ASC-H is associated with clinically significant disease. High-risk HPV-positive status in the triage for colposcopy of patients with ASC-US is associated with increased of CIN.

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