title: Non-16/18 high-risk HPV infection predicts disease persistence and progression in women with an initial interpretation of LSIL.
abstract: BACKGROUND
  The current management strategy for women with low-grade squamous intraepithelial lesions (LSILs) is inefficient and expensive because of the inability to identify patients at high risk for disease progression. The current study was designed to determine the genotypic patterns of human papillomavirus (HPV) associated with the persistence and progression of cervical lesions in women with an initial interpretation of LSIL.
  
  
  METHODS
  One hundred sixty-seven women with LSIL on Papanicolaou tests collected between December 1, 2009 and March 30, 2011 were studied. HPV DNA was extracted from residual SurePath specimens, genotypes were determined with a DNA microarray containing 40 HPV genotype probes, and microarray data were confirmed by sequencing. Follow-up Papanicolaou tests and/or biopsies were performed within a 20- to 46-month period after the initial diagnosis.
  
  
  RESULTS
  Ninety-seven of the 167 cases with follow-up results were included in the study. Compared with the women with a regressed cervical lesion, those with a persistent cervical lesion (PCL) were significantly more commonly infected with high-risk human papillomavirus (HR-HPV) genotypes (P < .01) and particularly with non-16/18 HR-HPV genotypes (P < .05). The PCL group also had a significantly higher average number of HR-HPV genotypes and non-16/18 HPV genotypes per specimen (P < .01). Infection with HPV-16/18 genotypes was not significantly associated with the persistence or progression of cervical lesions.
  
  
  CONCLUSIONS
  Infection with non-16/18 HR-HPV genotypes but not with HPV-16/18 genotypes was a strong predictor of the persistence and progression of cervical disease upon follow-up. Genotyping solely for HPV-16/18 would miss the majority of patients with LSIL who progress to high-grade squamous intraepithelial lesions. Pooled HR-HPV tests provide a better predictive value than HPV-16/18 genotyping alone in guiding the clinical management of patients with LSIL.
authors.affiliation: Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas.
authors.forename: Yasmin A
authors.initials: YA
authors.lastname: Lyons
authors.affiliation: Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas.
authors.forename: Aparna A
authors.initials: AA
authors.lastname: Kamat
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
authors.forename: Haijun
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
authors.forename: Dina R
authors.initials: DR
authors.lastname: Mody
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
authors.forename: Mary R
authors.initials: MR
authors.lastname: Schwartz
authors.affiliation: Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, Texas.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hobday
authors.affiliation: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
authors.forename: Yimin
authors.initials: Y
authors.lastname: Ge
mesh_terms: D000328:Adult; D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000235:genetics / Q000473:pathology*; D002681:China / Q000453:epidemiology; D002908:Chronic Disease; D015331:Cohort Studies; D004279:DNA, Viral / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000235:genetics; D052161:Human papillomavirus 18 / Q000235:genetics; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000235:genetics / Q000473:pathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000235:genetics / Q000473:pathology* / Q000503:physiopathology
chemical_list: D004279:DNA, Viral
keywords: human papillomavirus (HPV); human papillomavirus genotyping; low-grade squamous intraepithelial lesion; non-16/18 high-risk human papillomavirus genotypes; persistent cervical dysplasia; progression of cervical disease