Comparison of Colposcopic Biopsy Results of Patients Who have Cytomorphological Normal but HPV 16-18 or Other High-Risk HPV Subtypes Positive

Abstract

Objective:Current guidelines suggest annual co-test follow-up in non-16/18 high-risk HPV positive patients without abnormal cytologic findings. Considering the relatively high false-negative rates of cervical cytology, a follow-up period of one year might constitute an additional risk for development of cervical malignancies in these patients. The current study aims to evaluate colposcopic biopsy results of cytologically normal patients detected to carry high risk HPV by screening tests. Materials and Methods:A total of 160 patients with normal cervical cytology and high-risk HPV subtypes who underwent colposcopic examination were included in the study. Patients were divided into two groups according to their HPV results: HPV 16-18 and other types (non-16/18 high-risk subtypes). ECC, cervical biopsy, LEEP/conization results were analyzed for both groups. Histopathological results of the groups were compared in terms of ≤LSIL, HSIL and cervical cancer rates. Results:Cervical biopsy results in the “16-18” group were assessed as HSIL in 40 (48.2%) patients, LSIL in 6 patients (7.2%) and normal in 37 (44.6%) patients. ECC results revealed HSIL in 9 (10.8%) patients and LSIL in 1 (1.2%) patient. Nineteen out of 42 patients who underwent LEEP/conization had HSIL (surgical margin positivity was reported in 4 cases), while 3 patients had LSIL. None of the cases had cervical carcinoma.Conclusion:The present study detected that 15.6% of women infected with non-16/18 high-risk HPV subgroups developed ≥HSIL lesions. Although this rate seems lower than HPV 16-18 group, it is still too high to be overlooked. In conclusion, we suggest further clinical trials with larger number of patients to be conducted on this topic.

Risks for cervical abnormalities in women with non‐16/18 high‐risk human papillomavirus infections in south Shanghai, China

“…In our study, 12.18% of the HPV16 infected and 12.15% of the HPV18 positive women suffered from HSIL or SCC, followed by HPV51 (9.88%), HPV56 (8.82%), HPV66 (8.33%), and HPV52 (7.94%). HPV16 and 18 showed strong pathogenicity, which was consistent with previous literature reports 25,26 . We noted that 14.29% HPV73 positive women were diagnosed with HSIL.…”

“…In LSIL cases, non‐16/18 single and multiple HPV infections accounted for 66.78%, implying a higher risk of disease than HPV16/18. Therefore, the pathogenic risk of non‐16/18 HPV infection in samples from this region was significantly higher than the United States and European countries 26,27 . The top four most frequently infected HPV in HSIL (or SCC) patients were HPV16, HPV52, HPV18, HPV58.…”

Is cervical cytology testing as a part of co‐test unnecessary for HPV 16/18‐infected women? A retrospective cohort study of 1647 women

“…We found that the rate of CIN 2+ lesion was 18.6% in women with negative cytology. A study investigating cervical biopsy results in women with cytomorphological normal but HPV 16/18 positive reported that the rate of ≥HSIL lesions was 48.2% 19 . Han et al 20 found that one (1.6%) of 64 HPV‐infected patients with negative cytology had adenocarcinoma, two (3.1%) patients had adenocarcinoma in situ, and three (4.7%) patients had CIN 2/3.…”

Comparison of Colposcopic Biopsy Results of Non-HPV 16/18 Oncogenic Type Positive Patients

“…Aydoğmuş and Aydoğmuş (9) reported that the ratio of CIN 2+ lesions in cases of normal cytology results with non-16/18 HPV subtypes was 15.6%. Conversely, in another research, this ratio was reported as 0.01% (10).…”