title: Clinical performance of hybrid capture 2 human papillomavirus testing for recurrent high-grade cervical/vaginal intraepithelial neoplasm in patients with an ASC-US Papanicolaou test result during long-term posttherapy follow-up monitoring.
abstract: BACKGROUND
  Women who have been treated for high-grade cervical or vaginal intraepithelial neoplasia (CIN or VAIN) or invasive carcinoma are at risk for recurrent/persistent disease and require long-term monitoring. The role of human papillomavirus (HPV) testing in this setting is unclear.
  
  
  OBJECTIVE
  To evaluate the clinical performance of the Hybrid Capture 2 (HC2) HPV test for recurrent/residual high-grade CIN or VAIN in patients with a posttherapy abnormal squamous cells of undetermined significance (ASC-US) Papanicolaou test result.
  
  
  METHODS
  We reviewed the follow-up data on 100 patients who had an ASC-US Papanicolaou test and HC2 HPV results after treatment for high-grade CIN/VAIN or carcinoma. Human papillomavirus genotyping was performed for women with a negative HC2 result whose follow-up biopsy revealed CIN/VAIN 2+.
  
  
  RESULTS
  The patients' mean age was 47 years. The HC2 test result was positive in 33% of the patients. Follow-up biopsy was available for 17 of these patients (52%) and for 25 of the 67 patients (37%) with a negative HC2 result. A total of 5 of the patients (29%) with a positive HC2 result and 2 of the patients (8%) with a negative HC2 result had CIN/VAIN 3 on follow-up biopsy, a statistically insignificant difference (P = .10). Human papillomavirus 16/18 genotypes were detected in the CIN/VAIN 2+ lesions of 5 patients with a negative HC2 result.
  
  
  CONCLUSIONS
  HC2 yielded a false-negative rate of 8% for CIN 3. HC2 testing therefore may not be sufficient for triage of patients with an ASC-US Papanicolaou test result. Patients with ASC-US during long-term posttherapy follow-up need close monitoring, with colposcopic evaluation if clinically indicated.
authors.affiliation: From the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Drs Diaz De Vivar, Gong, Staerkel, and Guo, Mss Dawlett and Jack, and Mr Wang); and the Department of Pathology, Texas Children's Hospital Pavilion for Women, Houston (Dr Diaz De Vivar).
authors.forename: Andrea Diaz
authors.initials: AD
authors.lastname: De Vivar
authors.forename: Marilyn
authors.initials: M
authors.lastname: Dawlett
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Wang
authors.forename: Annie
authors.initials: A
authors.lastname: Jack
authors.forename: Yun
authors.initials: Y
authors.lastname: Gong
authors.forename: Gregg
authors.initials: G
authors.lastname: Staerkel
authors.forename: Ming
authors.initials: M
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification*; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000821:virology; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000821:virology; D065006:Papanicolaou Test / Q000379:methods; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000821:virology; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology; D014621:Vagina / Q000473:pathology; D014625:Vaginal Neoplasms / Q000175:diagnosis* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000821:virology
chemical_list: D004279:DNA, Viral