Medeiros F, Yuan L, Breslin G, Brodsky J, Saleemuddin A, Feldman S, Rushing L, Cviko A, Lee KR, Crum CP. Type-Specific HPV Testing as a Predictor of High-Grade Squamous Intraepithelial Lesion Outcome after Cytologic Abnormalities.
J Low Genit Tract Dis 2005;
9:154-9. [PMID:
16044055 DOI:
10.1097/01.lgt.0000171666.71600.9e]
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Abstract
OBJECTIVE
Human papillomavirus (HPV) risk assignment influences management after a cytologic diagnosis of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL). This study addressed whether type-specific HPV testing predicts risk of biopsy outcome of high-grade cervical intraepithelial neoplasia (CIN 2,3).
MATERIALS AND METHODS
A total of 162 ASCUS or LSIL diagnoses with colposcopic follow-up were evaluated and placed in 3 groups: Analysis 1: (high-risk HPVs including types 53 and 66; Analysis 2 (high-risk HPVs excluding types 53 and 66); and Analysis 3 (high-risk HPVs including type 53 and excluding type 66).
RESULTS
CIN 2,3 biopsy results followed low-risk HPVs in 0%, 3%, and 0% of scenarios 1, 2, and 3, respectively; 21%, 40%, and 27% of smears were classified as low risk, respectively. Of HPV 53 infections, 13.6% had CIN 2,3 biopsy outcomes.
CONCLUSIONS
Type-specific HPV testing accurately classifies a group of HPV-positive LSIL/ASCUS cases at low risk for CIN 2,3 at the first follow-up visit. Classifying HPV 53 as low-risk increases slightly the proportion of HSIL outcomes in the low-risk group, but may not increase cancer risk. HPV 53 merits designation as a high-risk HPV based only [corrected] on the proportion of CIN 2,3 in follow-up biopsy.
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