Testing for HPV as an objective measure for quality assurance in gynecologic cytology

Ko, Vincent; Nanji, Shabin; Tambouret, Rosemary; Wilbur, David C.

doi:10.1002/cncr.22488

Cited by 27 publications

(5 citation statements)

References 13 publications

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“…Our rates were similar to those reported in previous studies [8,22]: 37.08% (95% CI: 31.86-42.30%) of the women with ASC-US and 90.91% (95% CI: 84.89-97.33%) of those with LSIL were also infected with HR-HPV, as detected by HC2. Results from a meta-analysis showed HR-HPV prevalence rates in ASC-US and LSIL patients of 43% (95% CI: 40-46%; range 23-74%) and 76% (95% CI: 71-81%; range 55-89%), respectively [10].…”

Section: Discussionsupporting

confidence: 80%

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

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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.

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Section: Discussionsupporting

confidence: 80%

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

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“… 2 , 8 , 9 , 10 , 11 , 12 Furthermore, advancements that potentially simplify and minimize interpretive variance may foster wider utilization of digital technology in routine gynecological Pap test screening service. 5 , 11 , 12 , 13 , 14 …”

Section: Discussionmentioning

confidence: 99%

“…This process is ultimately complex and progressively confounded by increasing subjectivity thus associated with interpretive variance depending on sample characteristics, diagnostic pitfalls, and level of expertise. 4 , 13 , 14 These constructs may pose considerable diagnostic dilemmas particularly in cases revealing pronounced cytomorphologic overlap, as in those involving differential considerations for HSIL. 5 Of importance therefore, and particularly in the context of cervical cancer screening, digital imaging systems as BestCyte that optimize precision by standardizing the cell selection process through algorithm-driven classification, would facilitate cytologic principles by capturing and effectively displaying rare cellular events and diagnostic criteria upon which interpretations may be raised with confidence.…”

Section: Discussionmentioning

confidence: 99%

“…The relatively lower κ for ASCUS agrees with studies reporting the potential diagnostic uncertainties and pitfalls oftentimes experienced in this interpretation thus introduction of objective measures as ASCUS:SIL ratios and reflex Human Papilloma Virus molecular testing to help minimize ambiguous cytologic reporting hence unfavorable clinical ramifications. 12 , 13 , 14 , 15 Yet impact of κ analysis is reportedly dependent on the prevalence of disease hence frequency of diagnosis. Sorbye et al .…”

Section: Discussionmentioning

confidence: 99%

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BestCyte® Cell Sorter Imaging System: Primary and adjudicative whole slide image rescreening review times of 500 ThinPrep Pap test thin-layers - An intra-observer, time-surrogate analysis of diagnostic confidence potentialities

Chantziantoniou¹

2022

Journal of Pathology Informatics

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“…Furthermore, the percentage of ASC-US with a positive HR-HPV outcome was estimated, taking into consideration that, in January 2014, we introduced blind review of the ASC-US set as soon as the HR-HPV result test has been carried out [12,13,14,15,16,17,18]…”

Section: Methodsmentioning

confidence: 99%

Team Reading (Peer Review) of Suspicious/Positive Slides for Continuous Quality Improvement in Cervical-Vaginal Cytology: A Comparison between Methods and Indicators

et al. 2016

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Aim: In 2013, the Local Health Unit Roma 2 ex C screening laboratory introduced a new set of indicators for quality assurance. We compare 2 sets of indicators based on routine multiple readings (peer review) for their ability to identify problems in single-reader accuracy. Methods: All suspect slides were blindly reviewed by all the cytologists of the laboratory. The standard set of indicators includes interreader Cohen's kappa, positivity rate and atypical squamous cell of undetermined significance/squamous intraepithelial lesion (ASC-US/SIL) ratio. The new set included sensitivity for cervical intraepithelial neoplasia of grade 2 or worse (CIN2+), positive predictive value (PPV) and percentage of positive high-risk (HR)-HPV cases among ASC-US. In order to estimate sensitivity and PPV, we considered all women for whom there was a consensus of negative cytology, negative HR-HPV test, negative colposcopy or negative histology true negative. Results: Kappa values ranged from 0.521 to 0.753, with narrow 95% confidence intervals (CIs). Positivity rate ranged from 73.9 to 85.7 and the ASC-US/SIL ratio from 0.61 to 0.81. Sensitivity for CIN2+ at the low-grade SIL threshold ranged from 85.8 to 94.2, PPV ranged from 14.8 to 19.4, and both had a broad 95% CI. Readers with low sensitivity did not show low kappa values. The percentage proportion of HR-HPV-positives (HR-HPV+) among ASC-US ranged from 39.9 to 43.8% with a narrow 95% CI. Conclusion: The proportion of HR-HPV+ among ASC-US cases is a powerful indicator to address in training.

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Testing for HPV as an objective measure for quality assurance in gynecologic cytology

Cited by 27 publications

References 13 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

BestCyte® Cell Sorter Imaging System: Primary and adjudicative whole slide image rescreening review times of 500 ThinPrep Pap test thin-layers - An intra-observer, time-surrogate analysis of diagnostic confidence potentialities

Team Reading (Peer Review) of Suspicious/Positive Slides for Continuous Quality Improvement in Cervical-Vaginal Cytology: A Comparison between Methods and Indicators

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