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Cytology and Human Papillomavirus Screening Test Results Associated With 2827 Histopathologic Diagnoses of Cervical Intraepithelial Neoplasia 2/3
- Source :
- Archives of Pathology & Laboratory Medicine. 137:942-947
- Publication Year :
- 2012
- Publisher :
- Archives of Pathology and Laboratory Medicine, 2012.
-
Abstract
- Context.—Cervical screening in the United States increasingly involves newer US Food and Drug Administration–approved cytologic methods and adjunctive high-risk human papillomavirus (hrHPV) DNA testing.Objective.—To document cervical screening test performance preceding histopathologic cervical intraepithelial neoplasia (CIN) 2/3 diagnoses.Design.—Preceding screening test results with computer-imaged, liquid-based cytology (LBC) and hrHPV results were analyzed for 2827 patients with histopathologic CIN 2/3 diagnoses.Results.—Of 2827 patients with CIN 2/3 diagnoses, 2074 (73.4%) had system LBC findings within 4 months of CIN 2/3 diagnoses: high-grade squamous intraepithelial lesion (n = 862; 41.6%), low-grade squamous intraepithelial lesion (n = 464; 22.4%), atypical squamous cells of undetermined significance (n = 445; 21.5%), atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (n = 288; 13.9%), and atypical glandular cells/adenocarcinoma in situ (n = 15; 0.7%). Of the 2827 patients, 1488 (52.6%) also had earlier system LBC results at more than 4 months to 3 years before CIN 2/3 diagnoses: one or more abnormal LBC results (n = 978; 65.7%), one or more negative LBC results (n = 911; 61.2%), both abnormal and negative LBC (n = 401; 26.9%). Of 807 patients with hrHPV cotest results within 4 months of CIN 2/3 diagnoses, 786 (97.4%) had hrHPV+ results. Of 454 patients who also had earlier hrHPV results at more than 4 months to 3 years before CIN 2/3 diagnoses: 377 (83.0%) had one or more hrHPV+ result, 110 (24.2%) had one or more hrHPV− result, and 33 (7.3%) had both positive and negative HPV results.Conclusion.—Patients with histopathologic CIN 2/3 had recent abnormal LBC results, most often, high-grade squamous intraepithelial lesions. Among cotested patients, 97.4% (786 of 807) tested hrHPV+. However, a significant number of patients tested during an extended period of several years had earlier negative Papanicolaou or negative HPV test results, suggesting the recent development of some CIN 2/3 lesions and supporting the value of cotesting for enhanced detection of other developing, small, inaccessible, or nondiagnostic precursor lesions.
- Subjects :
- Adult
Pathology
medicine.medical_specialty
Adolescent
Screening test
Uterine Cervical Neoplasms
Atypical Squamous Cells
Cervical intraepithelial neoplasia
Pathology and Forensic Medicine
Young Adult
Cytology
medicine
Humans
Mass Screening
Papillomaviridae
Aged
Retrospective Studies
Aged, 80 and over
Vaginal Smears
Cervical screening
business.industry
Papillomavirus Infections
Human papillomavirus screening
General Medicine
Middle Aged
Pennsylvania
Uterine Cervical Dysplasia
medicine.disease
Medical Laboratory Technology
Squamous intraepithelial lesion
DNA, Viral
Female
Test performance
business
Papanicolaou Test
Subjects
Details
- ISSN :
- 15432165 and 00039985
- Volume :
- 137
- Database :
- OpenAIRE
- Journal :
- Archives of Pathology & Laboratory Medicine
- Accession number :
- edsair.doi.dedup.....6da7b88617215c9dfb1a2983e8119864
- Full Text :
- https://doi.org/10.5858/arpa.2012-0307-oa