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

Abstract

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.

<p>The Triage Effectiveness of an Extended High-Risk Human Papillomavirus Genotyping Assay for Women with Cytology Showing Atypical Squamous Cells of Undetermined Significance in China</p>

“…Thus, it is meaningful to identify the specific HR-HPV genotype model with higher sensitivity and specificity and lower referral rates to triage women with ASC-US. Previous reports 13,19 mainly evaluated the performance of HR-HPV or HPV16/18 genotyping in triaging patients with ASC-US. Nevertheless, data on HR-HPV types other than HPV16 and HPV18 are rare and inconsistent.…”

“…Previous reports 13 , 19 mainly evaluated the performance of HR-HPV or HPV16/18 genotyping in triaging patients with ASC-US. Nevertheless, data on HR-HPV types other than HPV16 and HPV18 are rare and inconsistent.…”

Performance of Different Combination Models of High-Risk HPV Genotyping in Triaging Chinese Women With Atypical Squamous Cells of Undetermined Significance

“…Most previous studies only evaluated the role of HPV16/18 or HR-HPV in triaging abnormal cervical cytology. Lin et al 's study evaluated the effect of HPV16/18 and other HR-HPV types in the triage of ASCUS and LSIL (19). Jiang et al 's study analyzed the role of 10 HR-HPV types in the triage 25–36 years old younger women with abnormal cytology (20).…”

Genotyping for Human Papillomavirus Types 16 and 18 in Women With Minor Cervical Lesions

“…An overview of study design, population, and test characteristics is provided in the Supplementary Tables 1-2. Additional data was obtained from the authors of most of the studies, with the exception of eight papers that contained all the absolute numbers required for computation of sensitivity and specificity (29,30,37,(47)(48)(49)(50)(51). Study settings included colposcopy clinics (30,32,(34)(35)(36)38,(40)(41)(42)(44)(45)(46)(49)(50)(51), primary screening settings (28,29,39,43,47), a maternity center (31), and pathology archives (33,37).…”