Human papillomavirus‐based triage of women showing a cervical cytology result of borderline or mild dyskaryosis

Arbyn, Marc; Martin‐Hirsch, Pierre L.; Wentzensen, Nicolas

doi:10.1111/j.1471-0528.2010.02521.x

Cited by 7 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, Castle et al [28 ]demonstrated that cytology combined with HPV 16/18 infection may indicate the immediate risk of CIN3+. The accuracy for detecting CIN2+ by HPV 16/18 and HR-HPV in women with ASC-US and LSIL in our study is consistent with the results of previous studies [12,29]. Genotyping for HPV 16/18 is much more specific, but at the expense of loss in sensitivity in the triage of women with ASC-US and LSIL.…”

Section: Discussionsupporting

confidence: 82%

Human Papillomavirus Genotyping to Predict the Risk of Cervical Precancerous Lesions or Cancer in Women with Minor Abnormal Cytology in China

Lin¹,

Cui²,

Zhang

et al. 2015

Acta Cytologica

View full text Add to dashboard Cite

Objective: To evaluate the role of human papillomavirus (HPV) genotyping in predicting the risk of cervical precancerous lesions or cancer in women with minor abnormal cytology. Methods and Materials: This study was conducted on 329 women with atypical squamous cells of undetermined significance (ASC-US) and 77 women with low-grade squamous intraepithelial lesions (LSIL) out of a total of 4,215 participants in a multicenter, cross-sectional study. Liquid-based cytology and the Hybrid Capture 2 test (HC2) were used to screen eligible women, and a Linear Array HPV genotyping test was performed on women with positive HC2 results. Results: The sensitivity and specificity for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+) based on HPV 16/18 were 82% [95% confidence interval (CI): 52-95%] and 91% (95% CI: 87-94%) in women with ASC-US and 67% (95% CI: 35-88%) and 84% (95% CI: 73-91%) in women with LSIL. The women infected with HPV 16/18 had a significantly higher risk of developing CIN2+ than those infected with other high-risk HPV types in both the ASC-US (OR 9.93, 95% CI: 2.02-48.88) and LSIL (OR 7.45, 95% CI: 1.60-34.68) arms. Conclusions: Genotyping for HPV 16/18 greatly improves specificity, but at the expense of potential sensitivity in the triage of minor cytology abnormalities. The role of genotyping for HPV 16/18 in order to triage women with minor abnormal cytology should be further evaluated in future studies.

show abstract

Section: Discussionsupporting

confidence: 82%

Human Papillomavirus Genotyping to Predict the Risk of Cervical Precancerous Lesions or Cancer in Women with Minor Abnormal Cytology in China

Lin¹,

Cui²,

Zhang

et al. 2015

Acta Cytologica

View full text Add to dashboard Cite

show abstract

“…Therefore, the study was not subjected to verification bias. Our findings of high sensitivity and high NPV for CIN2+ with hrHPV DNA testing are in accordance with the ASCUS-LSIL Triage Study and a meta-analysis of other HPV-based triage studies; however, these studies have focused on women with borderline or mild cervical dyskaryosis [21][22][23]. In our study, a majority (71%) of the patients had low-grade abnormalities (ASC-US/CIN1) on the initial Pap test after revision ( Table 1).…”

Section: Discussionsupporting

confidence: 75%

High-Risk Types of Human Papilloma Virus DNA Testing in Women with False Negative Cytology

et al. 2018

View full text Add to dashboard Cite

Objective: To determine whether high-risk types of human papilloma virus (hrHPV) DNA testing is reliable for selection patients in need of further investigation with colposcopy in women with increased risk of high-grade cervical lesions as a result of false negative cytology. The secondary objective was to compare the sensitivity of hrHPV testing on self-collected versus physician-collected samples for the detection of histological high-grade cervical intraepithelial neoplasia (CIN2+). Methods: Sixty-three patients identified with a missed abnormality following the re-evaluation of benign cervical cytology were included. A patient-collected and a physician-collected sample for HPV, colposcopy and cervical specimen collection for histology and cytology were performed. Results: The sensitivity of hrHPV testing of physician-collected samples for CIN2+ was 100% (95% CI 82.7–100), and the negative predictive value (NPV) was 100% (95% CI 93.3–100). The sensitivity of the self-sampling device to identify CIN2+ was 84.6% (95% CI 59.1–96.7), and the NPV was 94.4% (95% CI 83.4–98.8). The differences in the sensitivity and NPV between the 2 methods were non-significant. The agreement between the 2 methods regarding the HPV results was good, with a kappa value of 0.74 (95% CI 0.57–0.91). Conclusion: The current findings indicate that physician-collected samples for hrHPV DNA testing may be used as triage for the colposcopy of women with false negative cytology.

show abstract

“…In women 50 years or older, being hrHPVnegative was linked with a risk of CIN21/AIS1 that could be considered low enough to refer women to a next screening round. [57][58][59] However, in this group of women (AGC on cytology, hrHPV-negative, and 50 years), an elevated risk for extracervical malignancy was observed (risk of nHRC: 18%). The use of HPV DNA triage testing in the initial work-up of AGC, once an important component in the 2006 American guidelines, has been removed in the 2012 guidelines.…”

Section: Discussionmentioning

confidence: 69%

“…). In women 50 years or older, being hrHPV‐negative was linked with a risk of CIN2+/AIS+ that could be considered low enough to refer women to a next screening round . However, in this group of women (AGC on cytology, hrHPV‐negative, and ≥50 years), an elevated risk for extra‐cervical malignancy was observed (risk of nHRC: 18%).…”

Section: Discussionmentioning

confidence: 99%

High‐risk HPV testing in the management of atypical glandular cells: A systematic review and meta‐analysis

Verdoodt

Jiang

Williams

et al. 2015

Intl Journal of Cancer

View full text Add to dashboard Cite

Whereas the utility of high-risk HPV (hrHPV) testing is widely accepted in triage of women with atypical squamous lesions, its role in managing atypical glandular cells (AGC) is not fully elucidated. A systematic review and meta-analysis were performed to evaluate the accuracy of hrHPV testing in the management of women with AGC to detect underlying high-grade intraepithelial neoplasia or worse, and adenocarcinoma in situ or worse (AIS1). Additionally, the diagnosis of extra-cervical cancer was considered as an outcome in this review. A bibliographic database search (PubMed, EMBASE, CENTRAL) identified twelve eligible studies. The occurrence of cervical intraepithelial neoplasia grade two or worse including AIS1 (CIN21/AIS1), was 19.8% among women with AGC, and 55.7% among women with AGC and concurrent squamous lesions (atypical squamous cells of undetermined significance or worse, ASC-US1). The pooled sensitivity and specificity of hrHPV-testing with Hybrid Capture 2 (HC2) to detect CIN21/AIS1 in women with AGC was 90.0% (95% CI 5 85.1-93.4%) and 75.1% (95% CI 5 64.8-83.2%), respectively. Women who were hrHPV-negative, demonstrated an increased risk for extra-cervical malignancy (endometrium, fallopian tube, ovary). In women of 50y and older, a hrHPV-negative result was linked with a 18.0% chance of extra-cervical malignancy, while the chance of cervical pre-cancer and cancer was 0.4 and 0.0%, respectively. In conclusion, given the high risk of underlying CIN21/AIS1, women with AGC should be referred directly to colposcopy. However, hrHPV test results in combination with the age, appears to improve the diagnostic process by distinguishing the risk for cervical versus non-cervical lesions.

show abstract

Human papillomavirus‐based triage of women showing a cervical cytology result of borderline or mild dyskaryosis

Abstract: Please cite this paper as: Arbyn M, Martin-Hirsch P, Wentzensen N. HPV-based triage of women showing a cervical cytology result of borderline or mild dyskaryosis. BJOG 2010;117:641-644.

Cited by 7 publications

References 14 publications

Human Papillomavirus Genotyping to Predict the Risk of Cervical Precancerous Lesions or Cancer in Women with Minor Abnormal Cytology in China

Human Papillomavirus Genotyping to Predict the Risk of Cervical Precancerous Lesions or Cancer in Women with Minor Abnormal Cytology in China

High-Risk Types of Human Papilloma Virus DNA Testing in Women with False Negative Cytology

High‐risk HPV testing in the management of atypical glandular cells: A systematic review and meta‐analysis

Contact Info

Product

Resources

About