Utility of HPV DNA Detection in Thin-Layer, Liquid-Based Tests with Atypical Squamous Metaplasia

Quddus, M. Ruhul; Zhang, Shunli; Sung, C. James; Liu, Fang; Neves, Terry; Struminsky, Judy; Singer, Don B.

doi:10.1159/000327051

Cited by 9 publications

(9 citation statements)

References 21 publications

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“…ASM, a poorly characterized cervical lesion with uncertain biological and clinical significance, shares some but not all morphological features of SIL [43,44]. It has been shown that HPV positive ASM biopsies were significantly more likely to have concurrent or subsequent diagnosis of HSIL than HPV negative ones [43,45]. Unfortunately, the actual study is limited by the fact that it covers a single period and had no opportunity to follow up ASM HPV positive cases.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of cervical neoplastic lesions and Human Papilloma Virus infection in Egypt: National Cervical Cancer Screening Project

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Refaat

Dandash

2007

Infect Agents Cancer

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Background: Data from Egyptian studies provide widely varying estimates on the prevalence of premalignant and malignant cervical abnormalities and human papilloma virus (HPVs) infection. To define the prevalence and risk factors of pre-invasive and invasive cervical cancer (cacx), a community based full-scale cross sectional, household survey including 5453 women aged between 35 and 60 years was conducted.

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Section: Discussionmentioning

confidence: 99%

Prevalence of cervical neoplastic lesions and Human Papilloma Virus infection in Egypt: National Cervical Cancer Screening Project

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Refaat

Dandash

2007

Infect Agents Cancer

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“…Recently, almost all health care providers are moving a way from the conventional Papanicolaou smears and moving to what is called fluid-based technology that can provide more accurate interpretation and allows for molecular testing for the Human Papilloma Virus (HPV) infection. [69–72]…”

Section: Branches Of Cytopathologymentioning

confidence: 99%

“…The smears are superior to their conventional counterparts and also allow testing for Human Papilloma Virus DNA particles. [69–72] The cells are laid on the slide in a monolayer fashion and the background is cleanThe last groups of slides are those prepared using the Cellblock technique, as described above. Those slides are prepared utilizing formalin-fixed paraffin-embedded tissue.…”

Section: Technical Aspects Of Cytologymentioning

confidence: 99%

Basics of cytology

Al‐Abbadi

2011

Avicenna J Med

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This overview is intended to give a general outline about the basics of Cytopathology. This is a field that is gaining tremendous momentum all over the world due to its speed, accuracy and cost effectiveness. This review will include a brief description about the history of cytology from its inception followed by recent developments. Discussion about the different types of specimens, whether exfoliative or aspiration will be presented with explanation of its rule as a screening and diagnostic test. A brief description of the indications, utilization, sensitivity, specificity, cost effectiveness, speed and accuracy will be carried out. The role that cytopathology plays in early detection of cancer will be emphasized. The ability to provide all types of ancillary studies necessary to make specific diagnosis that will dictate treatment protocols will be demonstrated. A brief description of the general rules of cytomorphology differentiating benign from malignant will be presented. Emphasis on communication between clinicians and pathologist will be underscored. The limitations and potential problems in the form of false positive and false negative will be briefly discussed. Few representative examples will be shown. A brief description of the different techniques in performing fine needle aspirations will be presented. General recommendation for the safest methods and hints to enhance the sensitivity of different sample procurement will be given. It is hoped that this review will benefit all practicing clinicians that may face certain diagnostic challenges requiring the use of cytological material.

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“…ASC-R account for approximately 20%-50% of all ASCUS results in U.S. women and a lower percentage in European women (87)(88)(89)(90)(91). Because the prevalence of high-risk HPV types in ASC-R lesions is substantially lower than in other ASC lesions and because the positive predictive value of ASC-R for high-grade disease is minimal, HPV triage is probably not cost-effective for women with ASC-R results.…”

Section: Delineation Of the Categories Of Atypical Squamous Cells Accmentioning

confidence: 99%

Virologic versus cytologic triage of women with equivocal Pap smears: a meta-analysis of the accuracy to detect high-grade intraepithelial neoplasia

2004

The Women's Oncology Review

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Background:The appropriate management of women with minor cytologic lesions in their cervix is unclear. We performed a meta-analysis to assess the accuracy of human papillomavirus (HPV) DNA testing as an alternative to repeat cytology in women who had equivocal results on a previous Pap smear. Methods: Data were extracted from articles published between 1992 and 2002 that contained results of virologic and cytologic testing followed by colposcopically directed biopsy in women with an index smear showing atypical cells of undetermined significance (ASCUS). Fifteen studies were identified in which HPV triage and the histologic outcome (presence or absence of a cervical intraepithelial neoplasia of grade II or worse [CIN2؉]) was documented. Nine, seven, and two studies also documented the accuracy of repeat cytology when the cutoff for abnormal cytology was set at a threshold of ASCUS or worse, lowgrade squamous intraepithelial lesion (LSIL) or worse, or high-grade squamous intraepithelial lesion (HSIL) or worse, respectively. Random-effects models were used for pooling of accuracy parameters in case of interstudy heterogeneity. Differences in accuracy were assessed by pooling the ratio of the sensitivity (or specificity) of HPV testing to that of repeat cytology. Results: The sensitivity and specificity were 84.4% (95% confidence interval [CI] ‫؍‬ 77.6% to 91.1%) and 72.9% (95% CI ‫؍‬ 62.5% to 83.3%), respectively, for HPV testing overall and 94.8% (95% CI ‫؍‬ 92.7% to 96.9%) and 67.3% (95% CI ‫؍‬ 58.2% to 76.4%), respectively, for HPV testing in the eight studies that used the Hybrid Capture II assay. Sensitivity and specificity of repeat cytology at a threshold for abnormal cytology of ASCUS or worse was 81.8% (95% CI ‫؍‬ 73.5% to 84.3%) and 57.6% (95% CI ‫؍‬ 49.5% to 65.7%), respectively. Repeat cytology that used higher cytologic thresholds yielded substantially lower sensitivity but higher specificity than triage with the Hybrid Capture II assay. The ratio of the sensitivity of the Hybrid Capture II assay to that of repeat cytology at a threshold of ASCUS or worse pooled from the four studies that used both triage tests was 1.16 (95% CI ‫؍‬ 1.04 to 1.29). The specificity ratio was not statistically different from unity. Conclusion: The published literature indicates that the Hybrid Capture II assay has improved accuracy (higher sensitivity, similar specificity) than the repeat Pap smear using the threshold of ASCUS for an outcome of CIN2؉ among women with equivocal cytologic results. The sensitivity of triage at higher cytologic cutoffs is poor.

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Utility of HPV DNA Detection in Thin-Layer, Liquid-Based Tests with Atypical Squamous Metaplasia

Cited by 9 publications

References 21 publications

Prevalence of cervical neoplastic lesions and Human Papilloma Virus infection in Egypt: National Cervical Cancer Screening Project

Prevalence of cervical neoplastic lesions and Human Papilloma Virus infection in Egypt: National Cervical Cancer Screening Project

Basics of cytology

Virologic versus cytologic triage of women with equivocal Pap smears: a meta-analysis of the accuracy to detect high-grade intraepithelial neoplasia

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