Comparison of hrHPV Prevalence in over 1300 Computer-Imaged Liquid-Based Pap Samples with and without TZ/ECS
P Kaposi-Novak, C Zhao. Magee-Women's Hospital of UPMC, Pittsburgh, PA
Background: Sampling of the transformation zone and endocervical cells (TZ/EC) has been widely regarded as a quality indicator in cervical program; however, the significance of a TZ/EC sample in promoting disease detection remains controversy. The purpose of this study was to determine whether or not there is an association between hrHPV DNA test results and TZ/EC sampling in over 1300 LSIL ThinPrep samples.
Design: A computer-based search of Copath files of MWH, UPMC was carried out over a 34 month period (July 2005-April 2008) to retrieve women with ThinPrep Pap Test (TPPT) reported as LSIL who also were tested for hrHPV. All TPPT were processed and prepared using an automated processor and imaged using the ThinPrep Imaging System. hrHPV DNA was detected by HC2. hrHPV detection rates were compared between women with either presence or absence of a TZ/EC sample. Statistical analyses were performed by Chi-square test or Fisher's exact test for small number.
Results: A total of 1351 LSIL TPPT also underwent hrHPV DNA testing. hrHPV positive rate was higher in young women. There was a trend of decline in the hrHPV DNA prevalence in older women groups. hrHPV detection rate was significantly higher in women <40 compared with women 40 years and older (85.6% vs. 70.0%, p<0.001). No statistically significant difference of hrHPV prevalence was present between women with and without a TZ/ECS except for age 20-29 year group in which hrHPV rate was slightly higher in TZ/ECS present group than that in TZ/ECS absent group.
Table 1 - Comparison of Age-Specific hrHPV Prevalence among Women with LSIL TPPT with and without TZ/ECS (10-Year Intervals)*Fisher's exact test
|TZ/ECS Present||TZ/ECS Absent|
|Age Group||Tested No||Positive No||%||Tested No||Positive No||%||P Value|
Conclusions: This is the largest study to document hrHPV DNA detection rates in women with LSIL Pap tests with and without TZ/ECS. HC2 hrHPV DNA detection in LSIL TPPT vials is independent of cytologic sampling of TZ/ECS. hrHPV detection rate is lower in older women with LSIL Pap tests. Triage of older women with LSIL Pap test using hrHPV DNA testing might be helpful for these women's risk assessment.
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 23, Wednesday Morning