HPV 16/18 Genotyping in Assisting the Identification of Cervical Precancerous Lesions in Women with Negative Cervical Cytology and Positive High-Risk HPV Screening.
Hongxiu Ji, Cory Schneider. Eastside Pathology, Inc., Bellevue, WA
Background: Co-testing of cervical cytology and high-risk HPV DNA has been widely used for cervical cancer screening in women 30 years and older. A small percentage of those women will have discordant results, i.e., negative cytology and positive HPV. Given the significantly higher cancer risk involved with infections by HPV 16 and 18 compared to infections by other HPV types, the ASCCP has recently advised triaging those women using HPV 16/18 genotyping. If a woman has HPV 16 and 18 detected by genotyping, she will be referred to immediate colposcopy. If HPV 16/18 is negative, she will be followed-up with repeat cytology and high-risk HPV testing in 12 months. In this report, we present our experience with HPV 16/18 genotyping.
Design: During a 12-month period between May 2009 and April 2010, a total of 22,023 cytologically negative liquid-based cervical specimens were tested for the presence of high-risk HPV DNA by the Cervista HPV HR method. A portion of high-risk HPV positive cases were subject to HPV 16/18 genotyping per clinicians' request. A retrospective review was performed to identify all cases with subsequent biopsy diagnosis.
Results: HPV 16/18 genotyping was performed in 326 specimens among 1,214 cases that were positive for HPV DNA. HPV 16/18 DNA was found in 94 cases, with other high risk HPV types in the remaining cases. Subsequent biopsies were performed on 52 patients who were HPV 16/18 positive, 14 patients (26.9%) were found to have cervical precancerous lesions, including CIN 1 in 7 cases, CIN 2-3 in 6 cases and AIS in one case. On contrary, all HPV16/18 negative cases showed normal histology when subjected to histologic evaluation (0/10).
Conclusions: Our findings suggest that HPV 16/18 genotyping is capable of identifying cervical precancerous lesions that would otherwise be missed, including several cases of high grade squamous intraepithelial lesion and one adenocarcinoma in situ. HPV 16/18 genotyping could serve as a clinically useful tool in triaging women 30 years and older who have negative cervical cytology and positive HPV DNA screening results.
Category: Gynecologic & Obstetrics
Tuesday, March 1, 2011 9:30 AM
Poster Session III # 207, Tuesday Morning