Histopathologic Correlation Findings Associated with (Post-Hysterectomy) Vaginal Pap and HPV Test Results.
Chengquan Zhao, Mona Bansal, Marshall Austin. Magee Womens Hospital, University of Pittsburgh Medical Center, PA
Background: High risk (hr) HPV infection is recognized as the dominant etiology for cervical carcinoma. Data on prevalence of hrHPV DNA in patients with abnormal vaginal Pap results and the subsequent histopathologic findings are very limited. This is the largest study to date correlating histopathologic follow-up findings associated with (Post-Hysterectomy) vaginal Pap and hrHPV test results.
Design: A computer-based search from our Copath files was conducted over a study period of 49 months between July 1, 2005 and July 30, 2009 to identify vaginal ThinPrep Pap test (TPPT) cytology cases reported as ASC-US, ASC-H, LSIL, or HSIL for which Hybrid Capture 2 (HC2) hrHPV DNA test results were also reported. Vaginal Pap and HPV test results and histopathologic follow-up outcomes were analyzed.
Results: During the study period there were 1320 vaginal Pap tests reported as ASC-US, ASC-H, LSIL, or HSIL which also had HPV testing. The prevalence of hrHPV infection in women with abnormal vaginal Paps is shown in Table 1. The average age of patients with vaginal ASC-US results was 56.5 (17-91), with ASC-H 58.9 (22-87), with LSIL 56.9 (27-92), and with HSIL 63.4 (42-93). 86 women with vaginal LSIL, ASC-H, HSIL cytology and hrHPV DNA testing had at least one follow-up biopsy. 373 women with vaginal ASC-US and HPV test results had cytologic and/or biopsy follow up results. The follow-up results are shown in Table 2.
|HPV Pos F/U#||VAIN2/3 (%)||VAIN1 (%)||HPV Neg F/U#||VAIN2/3 (%)||VAIN1 (%)|
|ASC-US||138||7 (5)||59 (43)||235||1 (0.4)||10 (4)|
|ASC-H||16||1 (6)||14 (88)||8||1 (13)||2 (25)|
|LSIL||48||7 (15)||34 (71)||11||0 (0)||7 (64)|
|HSIL||2||2 (100)||0||1||1 (100)||0 (0)|
|Total||204||17 (8)||107 (53)||255||3 (1)||19 (8)|