Updates in Cervical Cancer Screening Guidelines, The Bethesda System for Reporting Cervical Cytology, and Clinical Management Recommendations

Wang, Tiannan; Zhang, Huina; Liu, Yang; Zhao, Chengquan

doi:10.14218/jctp.2023.00004

Cited by 4 publications

(2 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Three experimental clinicians and two expert pathologists from tertiary hospitals annotated scanned slides, adhering to TBS-2014 guidelines (18). In detail, digital images were divided into three non-repetitive sets for annotation by distinct medical professionals.…”

Section: Image Annotationmentioning

confidence: 99%

AI-assisted system improves the work efficiency of cytologists via excluding cytology-negative slides and accelerating the slide interpretation

Du,

Dai,

Zhou

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

Given the shortage of cytologists, women in low-resource regions had inequitable access to cervical cytology which plays an pivotal role in cervical cancer screening. Emerging studies indicated the potential of AI-assisted system in promoting the implementation of cytology in resource-limited settings. However, there is a deficiency in evaluating the aid of AI in the improvement of cytologists’ work efficiency. This study aimed to evaluate the feasibility of AI in excluding cytology-negative slides and improve the efficiency of slide interpretation. Well-annotated slides were included to develop the classification model that was applied to classify slides in the validation group. Nearly 70% of validation slides were reported as negative by the AI system, and none of these slides were diagnosed as high-grade lesions by expert cytologists. With the aid of AI system, the average of interpretation time for each slide decreased from 3 minutes to 30 seconds. These findings suggested the potential of AI-assisted system in accelerating slide interpretation in the large-scale cervical cancer screening.

show abstract

Section: Image Annotationmentioning

confidence: 99%

AI-assisted system improves the work efficiency of cytologists via excluding cytology-negative slides and accelerating the slide interpretation

Du,

Dai,

Zhou

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“… 4 Commercially available HPV vaccines, including the 2/4-valent vaccine (HPV16/18 plus HPV6/11) and the 9-valent vaccine (HPV16/18/31/33/45/52/58 plus HPV6/11), mainly prevent certain HPV genotype-associated infections, precancers and cancers. 5 Other HR-HPV genotypes have not been well studied for their oncogenic potential due to low prevalence and pooled HPV testing. Generally, the prevalence and genotype distribution of HPV varies in different regions, populations, socioeconomic statuses, ages and underlying disease states.…”

mentioning

confidence: 99%

Comprehensive overview of genotype distribution and prevalence of human papillomavirus in cervical lesions

Ye,

Jones,

Wang

et al. 2024

gocm

Self Cite

View full text Add to dashboard Cite

Across cervical squamous and glandular lesions, a spectrum of human papillomavirus (HPV) genotypes has been identified. This review aims to provide a comprehensive summary detailing the distribution and profile of HPV genotypes detected in cervical lesions, leveraging insights from histological and cytological findings. High-risk HPV (HR-HPV) genotypes exhibit varying degrees of oncogenic potential, with HPV16 and HPV18 identified as the most prevalent and oncogenic types. The distribution of HR-HPV genotypes varies among different degrees of the cervical lesions and varies between squamous and glandular neoplasia. HPV16 is predominantly associated with severe lesions (precancers and carcinomas), while HPV18 demonstrates a significantly higher prevalence in endocervical as compared with squamous neoplasia. The distribution of HR-HPV in severe squamous lesions is complex, involving many HR-HPV genotypes in addition to HPV16, while the distribution of HR-HPV genotypes in endocervical glandular lesions is mainly limited in HPV18 and HPV16.Large datasets from China have identified the three most common HR-HPV genotypes in this population as stratified by diagnostic category: HPV52, HPV16, HPV58 in histologically negative cases and cervical intraepithelial neoplasia 1 (CIN1); HPV16, HPV52, HPV58 in CIN2/3; HPV16, HPV58, HPV52 or HPV18 in squamous cell carcinoma (SCC); HPV16, HPV18 and HPV52 in endocervical adenocarcinoma in situ (AIS), invasive adenocarcinoma, as well as mixed squamous and glandular lesions. HPV33 is the fourth most common HPV type in CIN2/3 and SCC, while HPV45 occurs more commonly in AIS and adenocarcinoma, compared with squamous lesions. The prevalence and distribution of multiple HR-HPV coinfections vary across different cervical diseases. The clinical significance and pathogenesis of these multiple HR-HPV infections remain uncertain, although recent two large studies demonstrate that multiple HR-HPV infections are not associated with cumulatively higher risk of high-grade cervical squamous lesion development, suggesting competitive and/or cooperative interactions among HPV genotypes. Extensive HPV genotyping aids in risk assessment and optimising clinical approaches for women with mild abnormalities in Pap cytology. Women with atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) Pap test results and with the infection of some HR-HPV genotypes carry a very low risk of high-grade cervical lesions. HPV genotyping can allow for risk stratification and triage optimisation for these HR-HPV-positive women. Women with atypical glandular cell (AGC) Pap test results showed a specific HPV genotyping pattern and extended HPV genotyping may be helpful for the clinical management of AGCs. Continual advancements in clinical guidelines integrating extended genotyping would increase diagnostic accuracy and refine strategies in clinical management.

show abstract

Genotype profile of HPV in ASC‐H cytology and histologic follow‐up—prevalence, distribution, and risk: A retrospective study of 1414 cases

Sun,

Wang,

Zhong

et al. 2024

Cancer Cytopathology

View full text Add to dashboard Cite

BackgroundA cytologic diagnosis of atypical squamous cells, cannot exclude high‐grade squamous lesion (ASC‐H) poses a disproportionately high risk of cervical cancer development. The objective of this study was to analyze type‐specific risks by mapping human papillomavirus (HPV) genotypes in ASC‐H cytology.MethodsIn total, 1,048,581 Papanicolaou tests that had ASC‐H cytology were retrieved. Concurrent HPV genotyping using proprietary multiplex real‐time (MRT) and polymerase chain reaction (PCR) HPV tests and histologic follow‐up findings were analyzed.ResultsAmong 1678 patients who had ASC‐H findings (0.16%), 1414 (84.3%) underwent concurrent HPV genotyping (MRT, 857; HPV PCR test, 557). The overall high‐risk HPV (hrHPV)‐positive rate was 84.4%. Of the 857 MRT cases, 63.9% were infected with a single hrHPV, and 24.4% had multiple genotypes. The most prevalent HPV types were HPV16/52/58/33/31. Lesions that were identified as cervical intraepithelial neoplasia 2 or worse (CIN2+) were detected in 498 of 906 cases (55.0%), including 81 cervical carcinomas (8.9%). The risk of CIN2+ for the composite group of HPV16/52/58/33/31‐positive cases was 62.7%, representing 90.7% (264 of 291) of total CIN2+ lesions in ASC‐H/hrHPV–positive cases by MRT. CIN2+ lesions were detected in 108 of 142 (76.1%) HPV16‐positive and/or HPV18‐positive women by the PCR the HPV test. Among 128 hrHPV‐negative ASC‐H cases by both methods, CIN2+ lesions were identified in 21 of 128 (16.4%), including five cervical carcinomas (3.9%). The sensitivity, specificity, positive predictive value, and negative predictive value for patients in the composite group with HPV16/52/58/33/31 were 88.0%, 40.8%, 62.7%, and 75.0%, respectively.ConclusionsPapanicolaou tests classified as ASC‐H are associated with a high CIN2+ rate and warrant colposcopy, regardless of HPV status. The extent to which the risk‐stratification provided by comprehensive HPV genotyping can inform the management of ASC‐H cytology remains to be explored.

show abstract

Updates in Cervical Cancer Screening Guidelines, The Bethesda System for Reporting Cervical Cytology, and Clinical Management Recommendations

Cited by 4 publications

References 46 publications

AI-assisted system improves the work efficiency of cytologists via excluding cytology-negative slides and accelerating the slide interpretation

AI-assisted system improves the work efficiency of cytologists via excluding cytology-negative slides and accelerating the slide interpretation

Comprehensive overview of genotype distribution and prevalence of human papillomavirus in cervical lesions

Genotype profile of HPV in ASC‐H cytology and histologic follow‐up—prevalence, distribution, and risk: A retrospective study of 1414 cases

Contact Info

Product

Resources

About