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Original Article
Use of high-risk human papillomavirus testing in patients with low-grade squamous intraepithelial lesions
Article first published online: 5 JUL 2011
DOI: 10.1002/cncy.20172
Copyright © 2011 American Cancer Society
Additional Information
How to Cite
Levi, A. W., Harigopal, M., Hui, P., Schofield, K. and Chhieng, D. C. (2011), Use of high-risk human papillomavirus testing in patients with low-grade squamous intraepithelial lesions. Cancer Cytopathology, 119: 228–234. doi: 10.1002/cncy.20172
Publication History
- Issue published online: 12 AUG 2011
- Article first published online: 5 JUL 2011
- Manuscript Accepted: 9 MAY 2011
- Manuscript Revised: 18 APR 2011
- Manuscript Received: 30 JAN 2011
- Abstract
- Article
- References
- Cited By
Keywords:
- high-risk human papillomavirus (HPV) testing;
- triage of low-grade squamous intraepithelial lesion (LSIL);
- gynecologic cytology;
- Papanicolaou (Pap) test;
- follow-up of LSIL
High-risk human papillomavirus testing is highly sensitive for detecting cervical intraepithelial neoplasia 2 and more severe lesions in women with low-grade squamous intraepithelial lesions. Its use as a triaging tool may be indicated in women aged ≥ 30 years.
Abstract
BACKGROUND
The role of testing for high-risk human papillomavirus (HR HPV) when triaging women with a cytologic diagnosis of low-grade squamous intraepithelial lesion (LSIL) has not been well established. The objective of the current study was to correlate the status of HR HPV with the incidence of cervical intraepithelial neoplasia 2 and more severe lesions (CIN 2+) on tissue follow-up in women with LSIL.
METHODS
A total of 1046 women with LSIL and HR HPV testing were identified in the database of a large teaching hospital within a 12-month period. HR HPV testing was performed using the Hybrid Capture 2 assay with 1 relative light unit/cutoff as the cutoff.
RESULTS
Of the 1046 women with LSIL and concurrent HR HPV testing, 82.3% tested positive for HR HPV, 91.1% of whom were women aged < 30 years and 73% of whom were women aged ≥ 30 years (P < .001). Cytologic and/or histologic follow-up was available in 979 (93.6%) women; 25.5% had negative follow-up, 62.5% were found to have CIN 1 lesions, and 12.0% had CIN 2+ lesions. The sensitivity and negative predictive value of HR HPV status as a marker of CIN 2+ lesions were 98.3% and 98.9%, respectively. The colposcopy rate was 73.3% and 96.9% for women aged ≥ 30 years and women aged < 30 years, respectively (P = .01).
CONCLUSIONS
Using 1 RLU/CO as the cutoff value, HR HPV testing was found to be highly sensitive for detecting CIN 2+ lesions in women with LSIL. The colposcopy rate was significantly lower in women aged ≥ 30 years compared with women aged < 30 years. Triaging with HR HPV testing may be indicated in women aged ≥ 30 years with LSIL cytology, but not in women aged < 30 years. Cancer (Cancer Cytopathol) 2011;. © 2011 American Cancer Society.