title: High-Grade Cervical Intraepithelial Neoplasia Detected by Colposcopy-Directed or Random Biopsy Relative to Age, Cytology, Human Papillomavirus 16, and Lesion Size.
abstract: OBJECTIVE
  The aim of the study was to determine whether p16 positive/cervical intraepithelial neoplasia (CIN) 2, 3, and cancer (p16 + CIN 2/3+) detected by colposcopy-directed or random biopsy differ by age, referral cytology, human papillomavirus (HPV) 16, and lesion size.
  
  
  METHODS
  Data from the Shenzhen Cervical Cancer Screening Trial II where, at colposcopy, women who had directed and random cervical biopsies were reviewed to find women with CIN 2, 3, or cancer; 227 such women identified had their paraffin-embedded tissue blocks recut, reviewed, and then immune stained for p16. Data were analyzed by χ, Fisher exact test, and linear regression.
  
  
  RESULTS
  After histopathologic review and p16 staining of CIN 2, 175 women were diagnosed with p16 + CIN 2/3+. When compared with those diagnosed by colposcopy-directed biopsy (n = 138), those diagnosed by random biopsy (n = 37) were more likely to have Cytology-Lo (cytology of negative, atypical squamous cells of undetermined significance, or low-grade squamous intraepithelial lesion; p = .07), less likely to have HPV 16 (p = .041), more likely to be 51 years or older (p = .022), and more likely to have 1 quadrant lesions (p < .001). Logistic regression analysis showed p16 + CIN 2/3+ diagnosed by random biopsy was predicted by 1 quadrant lesions (p < .0001) and age of 51 years or older (p = .03) but not by Cytology-Lo (p = .71) nor HPV 16 (p = .26).
  
  
  CONCLUSIONS
  Women with p16 + CIN 2/3+ diagnosed by random biopsy are older and less likely to have HPV 16; hence, CIN diagnosed by random biopsy may not be as virulent as CIN diagnosed by colposcopy-directed biopsy. Regardless, we advise that CIN diagnosed by random biopsy be viewed like CIN diagnosed by colposcopy-directed biopsy.
authors: 1Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital; 2Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecological Diseases, Shenzhen, PR China; 3Department of Obstetrics and Gynecology, Kaiser Fontana California, Fontana, CA; 4Department of Anatomic and Molecular Pathology, Cleveland Clinic; 5Women's Health Institute, Cleveland Clinic, Cleveland; and 6Preventive Oncology International, Inc, Cleveland Heights, OH.
authors: Qing
authors: Q
authors: Chen
authors: Hui
authors: H
authors: Du
authors: Robert G
authors: RG
authors: Pretorius
authors: Chun
authors: C
authors: Wang
authors: Bin
authors: B
authors: Yang
authors: Guixiang
authors: G
authors: Wang
authors: Jinlong
authors: J
authors: Tang
authors: Jerome L
authors: JL
authors: Belinson
authors: Ruifang
authors: R
authors: Wu
mesh_terms: D000328:Adult; D000367:Age Factors; D001706:Biopsy / Q000379:methods*; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology; D002681:China; D003127:Colposcopy; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology