title: Histopathologic follow-up and human papillomavirus DNA test results in 290 patients with high-grade squamous intraepithelial lesion Papanicolaou test results.
abstract: BACKGROUND
  The study documents histopathologic outcomes and high-risk (hr) human papillomavirus (HPV) test results in a large cohort of patients with high-grade squamous intraepithelial lesion (HSIL) liquid-based cytology (LBC) Pap test results.
  
  
  METHODS
  A total of 352 patients with HSIL results (338 cervical and 14 vaginal) who had hrHPV testing and 290 patients with biopsy follow-up were studied. hrHPV detection rates were compared at different ages, with or without an endocervical/transformation zone sample (EC/TZS), and for cervical and vaginal HSIL Pap smears. Histopathologic follow-up findings were also compared. hrHPV-negative HSIL slides were re-evaluated in a blinded manner.
  
  
  RESULTS
  A total of 325 of 338 (96.2%) cervical HSIL and 12 of 14 (87.5%) vaginal HSIL tested hrHPV-positive. A total of 271 of 281 (96.4%) EC/TZS-positive cervical HSIL and 54 of 57 (94.7%) EC/TZS-negative cervical HSIL tested hrHPV-positive. The percentage of hrHPV-positive HSIL declined slightly with increasing age. 197 of 273 (72.3%) hrHPV-positive cervical HSIL had histopathologic cervical intraepithelial neoplasia (CIN) 2/3+ follow-up, including 8 squamous carcinomas, compared with 4 of 12 (33.3%) hrHPV-negative HSIL with CIN2/3 (no carcinomas). 167 of 241 (69.2%) EC/TZS-positive HSIL had CIN2/3+ follow-up, compared with 34 of 44 (77.3%) EC/TZS-negative HSIL. Equivocal HSIL morphology characterized some HPV-negative HSIL without CIN2/3+ follow-up.
  
  
  CONCLUSIONS
  hrHPV was detected in LBC vials from 96.2% of 338 cervical HSIL and 85.7% of 14 vaginal HSIL. CIN2/3+ was significantly more likely with hrHPV-positive cervical HSIL than with hrHPV-negative cervical HSIL. Presence or absence of an EC/TZS did not significantly impact HSIL hrHPV or CIN2/3+ rates. Some hrHPV-negative HSIL cases may represent HSIL cytologic mimics.
authors.affiliation: Department of Pathology, Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Faye F
authors.initials: FF
authors.lastname: Gao
authors.forename: R Marshall
authors.initials: RM
authors.lastname: Austin
authors.forename: Chengquan
authors.initials: C
authors.lastname: Zhao
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D002471:Cell Transformation, Neoplastic; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D014626:Vaginal Smears / Q000379:methods* / Q000592:standards
chemical_list: D004279:DNA, Viral