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Martins TR, Longatto-Filho A, Cohen D, Viscondi JYK, Fuza LM, Cury L, Villa LL, Levi JE, Eluf-Neto J. Influence of Prior Knowledge of Human Papillomavirus Status on the Performance of Cytology Screening. Am J Clin Pathol 2018; 149:316-323. [PMID: 29471316 DOI: 10.1093/ajcp/aqx163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the influence of prior knowledge of human papillomavirus (HPV) status in cervical cytopathology readings. METHODS Participants comprised 2,376 women who underwent parallel cytology and HPV-DNA testing. Smears were read twice by the same team, first with previous knowledge of HPV-DNA status. RESULTS Overall, 239 (10.2%) smears had their cytology classification altered by the HPV-informed review. Cytology readings with prior knowledge of the HPV status revealed 10.5% of abnormal smears (atypical squamous cells of undetermined significance or higher), while without prior knowledge, this rate dropped to 7.6%. When HPV status was informed, a significant increase in all categories of altered smears was observed. Cytology with prior knowledge of HPV status detected more cervical intraepithelial neoplasia grade 2 or higher (CIN 2+) compared with blinded: 86.7% vs 60.0%. CONCLUSIONS Our data indicate that cytology interpreted with prior knowledge of the HPV status provides higher sensitivity for CIN 2+ lesions while marginally reducing the overall specificity compared with HPV status blinded cytology.
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Affiliation(s)
- Toni Ricardo Martins
- Institute of Tropical Medicine, Virology Laboratory, Universidade de São Paulo, São Paulo, Brazil
- Department of Infectious Diseases, Universidade de São Paulo School of Medicine, São Paulo, Brazil
| | - Adhemar Longatto-Filho
- Laboratory of Medical Investigation (LIM) 14, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil
- Liffe and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Instituto Nacional de Ciência e Tecnologia das Doenças do Papilomavírus Humano, São Paulo, Brazil
| | - Diane Cohen
- Fundação Oncocentro de São Paulo, São Paulo, Brazil
| | | | - Luiz Mario Fuza
- Institute of Tropical Medicine, Virology Laboratory, Universidade de São Paulo, São Paulo, Brazil
- Fundação Oncocentro de São Paulo, São Paulo, Brazil
| | - Lise Cury
- Fundação Oncocentro de São Paulo, São Paulo, Brazil
| | - Luisa Lina Villa
- Instituto Nacional de Ciência e Tecnologia das Doenças do Papilomavírus Humano, São Paulo, Brazil
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | - José Eduardo Levi
- Institute of Tropical Medicine, Virology Laboratory, Universidade de São Paulo, São Paulo, Brazil
- Instituto Nacional de Ciência e Tecnologia das Doenças do Papilomavírus Humano, São Paulo, Brazil
| | - José Eluf-Neto
- Instituto Nacional de Ciência e Tecnologia das Doenças do Papilomavírus Humano, São Paulo, Brazil
- Fundação Oncocentro de São Paulo, São Paulo, Brazil
- Department of Preventive Medicine
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