Type-specific HPV testing as a predictor of high-grade squamous intraepithelial lesion outcome after cytologic abnormalities.
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).


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.
Medeiros
Fabiola
F
Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02130, USA.
Yuan
Liping
L
Breslin
Gillian
G
Brodsky
Joshua
J
Saleemuddin
Ashraf
A
Feldman
Sarah
S
Rushing
Lynda
L
Cviko
Aida
A
Lee
Kenneth R
KR
Crum
Christopher P
CP
D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D006801:Humans; D027383:Papillomaviridae / Q000145:classification* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications*; D011237:Predictive Value of Tests; D012306:Risk; D018570:Risk Assessment; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000821:virology