Screening test results associated with cancer diagnoses in 287 women with cervical squamous cell carcinoma.
BACKGROUND
The limitations of newer cervical screening tests are still being studied.


OBJECTIVE
To investigate those limitations, we conducted a retrospective review of 287 cases of cervical squamous cell carcinoma (SCC).


METHODS
A search through 5 years of records identified 287 women with cervical SCC diagnoses. Clinical history, histopathology, and liquid-based cytology (ThinPrep) and Hybrid Capture 2 (HC2) high-risk human papillomavirus (HPV) results were documented. Polymerase chain reaction HPV tests were performed on SCC tissues with prior negative HC2 results.


RESULTS
Of 287 women, 156 (54.4%) had abnormal cytology results, and 75 (26.1%) had abnormal clinical findings triggering tissue diagnoses of SCC. Among 156 patients with abnormal Papanicolaou (Pap) test results, more-seriously abnormal Pap test results were reported in 142 women (91.1%). Among 31 women with Pap and HC2 HPV cotesting within 1 year of SCC diagnoses, 28 (90%) were Pap⁺/HPV⁺, 2 (15.5%) were Pap⁺/HPV⁻, and 1 (3%) was Pap⁻/HPV⁻. Two of 3 women with negative HC2 results before SCC diagnosis had abnormal Pap results; 1 had negative Pap reports with questionable lesional cells mimicking atrophy. In all 3 cases of SCC with negative HC2 results, HPV-18 was detected; in 2 cases (66%), HPV-16 was also detected.


CONCLUSIONS
Although abnormal cytology preceded most SCC diagnoses, about one-third of patients were referred for diagnostic testing because of clinical suspicion alone. Among 31 SCC cases with liquid-based cytology and high-risk HPV cotest results less than 1 year before SCC diagnoses, 2 patients (6.5%) had Pap⁺/HPV⁻ results, and 1 patient (3.2%) had Pap⁻/HPV⁻ results. Polymerase chain reaction detected high-risk HPV DNA in tumor tissues of 3 SCC cases with recent HC2⁻ results.
Department of Pathology, Magee-Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Zaibo
Z
Li
R Marshall
RM
Austin
Ming
M
Guo
Chengquan
C
Zhao
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000302:isolation & purification; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology* / Q000821:virology*; D002584:Cervix Uteri / Q000473:pathology* / Q000821:virology*; D055088:Early Detection of Cancer / Q000379:methods*; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D012306:Risk; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology* / Q000821:virology*; D014626:Vaginal Smears; D055815:Young Adult