Management of borderline change in endocervical cells: a more dependable approach

Kodiathodi, S; Chattopadhyay, Supratik; Baldwin, Amy; Franks, Peter

doi:10.1038/bjc.2014.340

Cited by 4 publications

(7 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When abnormal test result was defined as positive with ASC‐US and HC2 (ASCUS‐HC2), the Pap test overlooked five CIN2/3 and VAIN2 cases, all of which were identified by one of the HPV tests (Table 1). This suggests a limitation in its usefulness for screening some cancers or premalignant lesions based on cell morphology, as reported previously 6,7 . Among the cases overlooked by the Pap test, HPV16 was identified in six (32%), HPV18 in five (26%).…”

Section: Discussionsupporting

confidence: 50%

“…Although the Pap test has reduced the incidence and mortality of cervical cancer, 5 it overlooks about one-third of cancer cases. 6,7 The combination of HPV testing and cytology has been evaluated in Europe and the United States and increased the detection rate of precancerous lesions (high-grade squamous-intraepithelial lesions [HSIL] and cervical intraepithelial neoplasia [CIN]2,3 in the first round of screening, resulting in a decrease in the incidence of HSIL and CIN2,3 in the second round. 8,9 This might be due to the ability of HPV tests, unlike the Pap test, to detect high-risk (HR)-HPV types, as suggested by four large randomized studies (NTCC, POBASCAM, ARTISTIC, and Swedescreen).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Aptima and hybrid capture‐2 HPV tests and Pap test in the referral population in Japan

Kuroki

Sakamoto

Shibata

et al. 2021

Journal of Medical Virology

View full text Add to dashboard Cite

The Aptima human papillomavirus (HPV) test (APTIMA) detects E6‐E7 mRNA in abnormal cells in the uterine cervix. To investigate the accuracy of APTIMA for cervical cancer screening in Japan, 423 subjects, mostly referrals with abnormal cytology or being followed up for cervical intraepithelial neoplasia (CIN)1, were screened using two HPV tests, hybrid capture 2 (HC2) and APTIMA, and by the Pap test. Colposcopy was conducted in all subjects with a positive result in either test type. HPV genotyping was performed by Genosearch‐31. A result of atypical squamous cells‐undetermined significance (ASC‐US) or worse on the HC2 test (ASC‐US‐HC2), and low‐grade squamous intraepithelial lesion (LSIL) or worse (LSIL+) on the Pap test, was regarded as positive. APTIMA (97.5%) was more sensitive than LSIL+ (85.1%) for detecting CIN2 or worse (CIN2+) (McNemar test; p = .0003), and more sensitive (98.6%) than ASC‐US‐HC2 (92.7%) for detecting CIN3+. APTIMA and HC2 had similar sensitivities. HPV genotyping revealed that CIN2/3 with high‐risk HPV (HR‐HPV) was overlooked in five cases by ASC‐US‐HC2, and in four cases by HC2, while no such lesions were missed by APTIMA. Thus, APTIMA might be superior to HC2 for primary HPV screening in Japan. One cancer case positive for HPV67 (potentially high risk, [pHR]) was overlooked by Pap test and both HPV tests, suggesting a need for a new HPV test able to detect pHR‐HPV types.

show abstract

Section: Discussionsupporting

confidence: 50%

mentioning

confidence: 99%

Comparison of Aptima and hybrid capture‐2 HPV tests and Pap test in the referral population in Japan

Kuroki

Sakamoto

Shibata

et al. 2021

Journal of Medical Virology

View full text Add to dashboard Cite

show abstract

“…Kodiathodi et al, found a significant proportion of women with negative colposcopy and nuclear borderline changes in endocervical cells, and the presence of H-SIL and carcinomas during the first year of follow-up. They propose to optimize the algorithm diagnosis to detect high grade histology and cancer in earlier stages [31].…”

Section: Hcc (412%mentioning

confidence: 99%

Hidden carcinoma of uterine cervix

BDalbert¹,

Peña²,

Falabella³

et al. 2016

Clin Obstet Gynecol Reprod Med

View full text Add to dashboard Cite

The objectives were to evaluate the prevalence of Hidden Cervical Cancer (HCC), to analyze diagnostic and histopathological aspects, and clinical evolution of 677 patients with cervical cancer, attended from January 1995 through December 2013. The design was retrospective and observational. The diagnostic methods used were cytology, colposcopy and histopathological study of surgical specimens. The HCC was found in 68/677 patients (10,04%): 55,9% of which consulted for a medical checkup, 33,8% for metrorragia, 19,1% for sinusorragia, 2,9% for bleeding and 1,5% for inguinal node; whereas 62% of the patients with exocervical or exoendocervical cancer (EEC) consulted for bleeding, 23% for sinusorragia and vaginal discharge with odor, and 16% for a medical checkup (p< 0.0003). The cytology's sensitivity for HCC was 47,1% (CI 95%, 35.2-59), 36,8% were false negatives; whereas for EEC it was 69,1% (CI 95%, 65.4-72.8) and 12,3% respectively (p< 0.001). The colposcopy's sensitivity for HCC was 17,65% (CI 95%, 8.6-26.7); whereas for EEC it was 85,55% (CI 95%, 82.8-88.4; p< 0.0001). 30,9% of the cases of HCC were diagnosed by biopsies and 41,2% by surgical procedures; whereas 89,3% of the cases of EEC were detected in biopsies and 7,22% in surgical pieces (p< 0.0002). The torpid evolution of the disease, its rapid progression and death was significantly greater in patients with HCC than in patients with EEC (34,43% vs. 17,1%; P< 0.002), since HCC was diagnosed in more advanced stages and it had 19,12% adenocarcinoma and adenosquamous histology vs. 8,37% in EEC.Conclusions: patients with HCC had a worse evolution and poor outcome significantly greater than in patients with EEC. The use of virological tests in the screening would allow to detect HCC in early stages.

show abstract

“…Cervical cytological screening was initially introduced to detect squamous cell dyskaryosis rather than glandular changes (abnormalities of columnar cells, most of which are located within the cervical canal). Borderline nuclear change (BNC) was described by the British Society of Clinical Cytology in 1986 and encompasses changes in glandular cells where dyskaryosis cannot be excluded; the incidence in the current literature is 0.5%‐1.8% …”

Section: Introductionmentioning

confidence: 99%

“…Borderline nuclear change (BNC) was described by the British Society of Clinical Cytology in 1986 and encompasses changes in glandular cells where dyskaryosis cannot be excluded 1 ; the incidence in the current literature is 0.5%-1.8%. 2 In 2012 Human Papillomavirus (HPV) triage of low-grade cytology was introduced in the UK as HPV is known to cause >99% of cervical cancers. 3,4 Public Health England released updated National Health Service (NHS) Cervical Screening Programme (CSP) guidance in 2016, 5 which recommended that all women with BNC in endocervical cells should have HPV testing; 99% of those with a positive result are to be seen in colposcopy within 6 weeks of the referral and 100% "should undergo colposcopy, any appropriate biopsy".…”

Section: Introductionmentioning

confidence: 99%

An audit of liquid‐based cytology samples reported as high‐risk human papillomavirus and borderline nuclear change in endocervical cells

2020

View full text Add to dashboard Cite

Introduction Primary human papillomavirus (HPV) screening, testing for the virus responsible for 99% of cervical cancers, was introduced in 2018‐2020 in the UK. This was preceded by HPV triage of low‐grade cytology from 2012. Much of the evidence incorporated into current National Health Service (NHS) colposcopy guidance assessed outcomes prior to this change in screening. The aim of this paper is to assess adherence to NHS cervical screening programme standards, determine the incidence of cases reported as high‐risk HPV plus borderline nuclear change in endocervical cells, to calculate colposcopic accuracy and assess histological outcomes in this cohort. Method A retrospective audit of women referred to a colposcopy clinic in one NHS trust from 2016 to 2018. Data relating to histological outcomes, cytological follow‐up and demographics were collected. Results Of 2001 referrals, 22 data sets identifying HPV‐positive borderline endocervical change were eligible for analysis (1.2% incidence). Median age was 29.5. Two‐thirds (68.2%, n = 15) had high‐grade dysplasia at diagnostic biopsy. Those women with reassuring histology had normal cytological follow‐up. Colposcopic accuracy was moderate (positive predictive value 43.8%, negative predictive value 100%). Conclusions Borderline nuclear change in endocervical cells is an uncommon condition but should be treated as a high‐grade referral. All women should be offered a diagnostic biopsy at the initial colposcopy; if no histopathological abnormality is identified, alternative sources of pathology should be considered. Excisional treatment should be recommended to unreliable attenders, those with a complete family and inadequate colposcopy (TZ3) and considered in younger women with a TZ3.

show abstract

Management of borderline change in endocervical cells: a more dependable approach

Cited by 4 publications

References 39 publications

Comparison of Aptima and hybrid capture‐2 HPV tests and Pap test in the referral population in Japan

Comparison of Aptima and hybrid capture‐2 HPV tests and Pap test in the referral population in Japan

Hidden carcinoma of uterine cervix

An audit of liquid‐based cytology samples reported as high‐risk human papillomavirus and borderline nuclear change in endocervical cells

Contact Info

Product

Resources

About