Immediate biopsy of cervical cytology‐negative and non‐HPV‐16/18 oncogenic types positive patients

Karaca, İbrahim; Öztürk, Mustafa; Comba, Cihan; Demirayak, Gökhan; Alay, Ismail; Erdogan, Sakir Volkan; Hoşgören, Murat; Yaşar, Levent

doi:10.1002/dc.23905

Cited by 9 publications

(17 citation statements)

References 19 publications

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“…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). Our research detected CIN 2+ lesions 4% of patients with negative cytology.…”

Section: Discussioncontrasting

confidence: 71%

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

Vural¹,

Karadeniz²,

Karadeniz³

et al. 2021

csmedj

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Objective: This study aimed to evaluate and compare the risk in detecting cervical intraepithelial neoplasia (CIN) 2+ or higher lesions by performing immediate colposcopy in patients with positive high-risk non-human papillomavirus (HPV) 16/18 subtypes, regardless of their cytology results. Material and Methods:A total of 264 patients with HPV-positive subtypes, aged 20-65 years, with any type of cervical cytology results were included in the study. A liquid-based cytologic cervical cancer screening with HPV testing was carried out between November 2020 and May 2021. Cytological specimens were classified according to the Bethesda system (2014), and HPV identification was analyzed with Cobas 4800 system. Colposcopy-guided endocervical curettage and endometrial biopsy were performed.Results: A total of 123 patients had HPV non-16/18 oncogenic types, wherein 34 (69.3%) had no dysplasia, 9 (18.3%) had CIN 1, and 2 (4.08%) had CIN 2-3. Conclusion:Colposcopic evaluation may be considered in cases of non-16/18 high-risk HPV subtypes with abnormal cytologic results. Among the patients who had negative cervical cytology and positive non-HPV-16/18, 4.08% were women with CIN 2-3. Following the algorithm according to the guidelines, there will be a risk of 4.08% of misdiagnosing CIN 2+ lesions by gynecologists. Organizing large-scale randomized controlled studies will help in understanding the meaning or importance of this topic.

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Section: Discussioncontrasting

confidence: 71%

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

Vural¹,

Karadeniz²,

Karadeniz³

et al. 2021

csmedj

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“…In the present study, the rates of presence of CIN 2+ and CIN 3+ lesions are more than the immediate risk of CIN 2+ and CIN 3+ for patients with HPV‐positive and NILM cytology reported in the 2019 ASSCP guideline. In another study of 169 patients with non‐HPV‐16/18 oncogenic types and negative cytology, 151 patients (89%) had no dysplasia, 16 patients (9.4%) had CIN 1, and 2 patients (1.1%) had CIN 2/3 24 . Vargas et al re‐evaluated 121 non‐16/18 hrHPV positive/cytology negative patients with co‐test at least one year later.…”

Section: Discussionmentioning

confidence: 99%

The meaning of high‐risk HPV other than type 16/18 in women with negative cytology: Is it really safe to wait for 1 year?

Kabaca

Giray

Uzun

et al. 2021

Diagnostic Cytopathology

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Background Human papillomavirus (HPV) is a primary risk factor for cervical cancer. HPV 16 and 18 are the two most carcinogenic genotypes and have been reported in the majority of cervical cancer. High‐risk HPVs (hrHPVs) other than HPV 16/18 cause approximately a quarter of cervical cancers. We aimed to present the colposcopy‐guided biopsy results of non‐16/18 hrHPV‐infected women with negative cytology. Methods This is a retrospective cohort study conducted on 752 patients between the ages of 30‐65 years with non‐16/18 hrHPV and negative cytology undergoing colposcopy‐guided biopsy at a tertiary gynecological cancer center between January‐2016 and January‐2019. Results The mean age of the women was 42.35±9.41 years. Cervical intraepithelial neoplasia (CIN) 2+ lesion was detected in 49 (6.5%) women with negative cytology. The rate of CIN 2+ lesions in women with abnormal cytology was 12.8%. Patients with abnormal cytology had about 2.1 and 2.4 times increased the odds of CIN 2+ lesion in cervical biopsy and endocervical curettage specimens, respectively. CIN 3+ lesion was detected in 20 (2.7%) women with negative cytology. One (0.1%) of the patients with HPV 39 and negative cytology had invasive cervical cancer. The two most common HPV subtypes were HPV 31 and HPV 51. Conclusions The risk of cervical preinvasive lesions still can be detected and cannot be completely eliminated among hrHPV other than 16/18‐infected women with negative cytology. Based on the results of this study, referral of non‐16/18 hrHPV‐infected women with negative cytology to colposcopy is supported as a credible and feasible strategy.

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“…We also determined that HPV 16/18 and oncogenic types significantly differed in terms of endocervical curettage biopsy results. Clinicians should consider that the possibility of cervical intraepithelial neoplasia is 23.8% for LGSIL and 6.2% for HGSIL in colposcopic biopsy and 4.3 % for LGSIL and 1.1% for HGSIL in endocervical curettage [31,32]. To reduce mortality and morbidity related to cervical cancer, more precise algorithms should be constituted [33].…”

Section: Discussionmentioning

confidence: 99%

Comparison of biopsy results of HPV 16/18 and non-16/18 HPV positive patients with a normal PAP test, a tertiary center experience

Koyuncu¹,

Kurt²,

Sakin³

et al. 2021

Journal of Surgery and Medicine

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Background/Aim: Optimal management for HPV positive and cytology negative patients remains a controversial issue. Immediate colposcopy is suggested for HPV 16/18 positive patients, whereas patients with non 16/18 HPV oncogenic virus positive are recommended to co-test after a year. In this study, we aim to compare the immediate colposcopic biopsy results between HPV 16/18 and non-16/18 HPV positive patients with cytology negative patients. Methods: In this prospective cross-sectional study, we included 1028 HPV positive and cytology negative patients who were screened for cervical cancer between January 2017 and 2019. Liquid based preparations were used for cytology samples (ThinPrep Pap Test). Cervical specimens were analyzed with Hybrid Capture for HPV types. Patients underwent colposcopic examination, biopsy procedure and endocervical curettage. Results: A total of 424 (41.2%) patients were HPV 16/18 positive, while 604 (58.8%) were non-16/18 oncologic HPV positive. Colposcopic biopsy results of the patients revealed that of the HPV 16/18 positive patients, 246 (23.9) had no dysplasia, 101 (9.8) had LGSIL and 77 (7.5%) had HGSIL. Among the non 16/18 positive patients, 422 (41.1%) had no dysplasia, 144 (14%) had LGSIL and 38 (3.7) had HGSIL. All patients were referred for endocervical curettage, which resulted as follows: Among HPV 16/18 patients, 384 (37.4%) had no dysplasia, 21 (2%) had LGSIL and 19 (1.8%) had HGSIL. Five hundred seventy-one non 16/18 positive patients had no dysplasia, 26 (2.5%) had LGSIL and 7 (0.7) had HGSIL. The comparison of colposcopic biopsy results of HPV 16/18 and non-16/18 HPV positive patients were different in terms of no dysplasia and HGSIL (P=0.001 and P=0.001, respectively), whileLGSIL results were similar. The endocervical curettage biopsy results of the patients revealed a significant difference in HGSIL results (P=0.03). The two groups were similar with respect to reports of no dysplasia and LGSIL. Conclusion: Direct referral of the patients, who are expected to be lost to follow-up, could be convenient for non-16/18 HPV positive patients with negative cytology to reduce progression of cervical cancer and the psychological burden of HPV positivity.

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Immediate biopsy of cervical cytology‐negative and non‐HPV‐16/18 oncogenic types positive patients

Abstract: For the patients who had cervical cytology negative/non-HPV-16/18 positive, we detected that 1.1% of these women had CIN 2-3. For this reason, by chasing the algorithm recommended by guidelines, gynecologists take risk missing a diagnosis of CIN 2 plus lesion in 1.1% of patients.

Cited by 9 publications

References 19 publications

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

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

The meaning of high‐risk HPV other than type 16/18 in women with negative cytology: Is it really safe to wait for 1 year?

Comparison of biopsy results of HPV 16/18 and non-16/18 HPV positive patients with a normal PAP test, a tertiary center experience

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