Morphologic, patient and interpreter profiles of high-risk human papillomavirus-positive vs.-negative cases of atypical squamous cells of undetermined significance.
OBJECTIVE
To define the morphologic and patient profiles, if any, that distinguish high-risk human papillomavirus (HR-HPV)-positive atypical squamous cells of undetermined significance (ASCUS) from HR-HPV-negative ASCUS and to compare individual and laboratory reporting rates with the national averages.


METHODS
One hundred fifty liquid-based cervicovaginal preparations (ThinPrep, Cytyc Corporation, Boxborough, Massachusetts, U.S.A.) with a diagnosis of ASCUS and a reflex HR-HPV test were assessed for the following features: background patient information, cell morphology, cell patterns and interpreter profiles. Fisher's Exact test (2-tailed) was used to calculate the exact probability of obtaining results by chance.


RESULTS
The median age of the HR-HPV-positive patients was approximately 11 years younger than the HPV-negative group, and pregnant patients were also more apt to be HPV positive. Atypical cells in greater numbers and in groups as opposed to single cells correlated more often with HR-HPV-positive individuals. Koilocytelike changes and parakeratosis were more frequently associated with HR-HPV, but the presence of Trichomonas was usually a negative predictor.


CONCLUSIONS
In cases diagnosed as ASCUS, there are certain cytologic features and patient types that are more likely to be associated with HR-HPV positivity. This could be used in everyday practice to further fine tune the diagnosis of ASCUS. Monitoring individual and laboratory ASCUS rates with HR-HPV positivity can be an important quality improvement indicator.
Department of Pathology, The Methodist Hospital, 6565 Fannin, M227, Houston, Texas 77030, USA.
Sharon
S
Steinman
Deborah
D
Smith
Nancy
N
Chandler
Bakula
B
Dhurandhar
Liza
L
Di Filippo
Miriam
M
Scheiber-Pact
Dina R
DR
Mody
D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D018307:Neoplasms, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D027383:Papillomaviridae / Q000235:genetics / Q000472:pathogenicity*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D011230:Precancerous Conditions / Q000145:classification / Q000175:diagnosis* / Q000473:pathology; D011247:Pregnancy; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000821:virology
D004279:DNA, Viral