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Histopathologic follow-up and human papillomavirus DNA test results in 290 patients with high–grade squamous intraepithelial lesion papanicolaou test results†
Article first published online: 19 JUL 2011
Copyright © 2011 American Cancer Society
Volume 119, Issue 6, pages 377–386, 25 December 2011
How to Cite
Gao, F. F., Austin, R. M. and Zhao, C. (2011), Histopathologic follow-up and human papillomavirus DNA test results in 290 patients with high–grade squamous intraepithelial lesion papanicolaou test results. Cancer Cytopathology, 119: 377–386. doi: 10.1002/cncy.20176
The authors acknowledge and thank Chunqiao Tian, PhD (Biostatistician, Precision Therapeutics, Inc), for his direction and review of the statistical analysis. The authors also acknowledge cytopathologists Jing Yu, MD, Olga Navolotskaia, MD, Tee Lang, MD, and Payam Arya, and cytotechnologists Joseph Beere, Amy Colaizzi, Rose Crane, Jonee Matsko, and Xin Zhao for participating in blinded slide reviews.
- Issue published online: 14 DEC 2011
- Article first published online: 19 JUL 2011
- Manuscript Accepted: 16 MAY 2011
- Manuscript Revised: 5 MAY 2011
- Manuscript Received: 28 MAR 2011
- histopathologic follow-up;
- transformation zone;
The study documents histopathologic outcomes and high-risk (hr) human papillomavirus (HPV) test results in a large cohort of patients with high-grade squamous intraepithelial lesion (HSIL) liquid-based cytology (LBC) Pap test results.
A total of 352 patients with HSIL results (338 cervical and 14 vaginal) who had hrHPV testing and 290 patients with biopsy follow-up were studied. hrHPV detection rates were compared at different ages, with or without an endocervical/transformation zone sample (EC/TZS), and for cervical and vaginal HSIL Pap smears. Histopathologic follow-up findings were also compared. hrHPV-negative HSIL slides were re-evaluated in a blinded manner.
A total of 325 of 338 (96.2%) cervical HSIL and 12 of 14 (87.5%) vaginal HSIL tested hrHPV-positive. A total of 271 of 281 (96.4%) EC/TZS-positive cervical HSIL and 54 of 57 (94.7%) EC/TZS-negative cervical HSIL tested hrHPV-positive. The percentage of hrHPV-positive HSIL declined slightly with increasing age. 197 of 273 (72.3%) hrHPV-positive cervical HSIL had histopathologic cervical intraepithelial neoplasia (CIN) 2/3+ follow-up, including 8 squamous carcinomas, compared with 4 of 12 (33.3%) hrHPV-negative HSIL with CIN2/3 (no carcinomas). 167 of 241 (69.2%) EC/TZS-positive HSIL had CIN2/3+ follow-up, compared with 34 of 44 (77.3%) EC/TZS-negative HSIL. Equivocal HSIL morphology characterized some HPV-negative HSIL without CIN2/3+ follow-up.
hrHPV was detected in LBC vials from 96.2% of 338 cervical HSIL and 85.7% of 14 vaginal HSIL. CIN2/3+ was significantly more likely with hrHPV-positive cervical HSIL than with hrHPV-negative cervical HSIL. Presence or absence of an EC/TZS did not significantly impact HSIL hrHPV or CIN2/3+ rates. Some hrHPV-negative HSIL cases may represent HSIL cytologic mimics. Cancer (Cancer Cytopathol) 2011;. © 2011 American Cancer Society.