[1159] 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 results associated with abnormal vaginal Paps
 #Case#Positive%
ASC-US112524422
ASC-H362158
LSIL14811376
HSIL11982
Total132038729




 HPV Pos F/U#VAIN2/3 (%)VAIN1 (%)HPV Neg F/U#VAIN2/3 (%)VAIN1 (%)
ASC-US1387 (5)59 (43)2351 (0.4)10 (4)
ASC-H161 (6)14 (88)81 (13)2 (25)
LSIL487 (15)34 (71)110 (0)7 (64)
HSIL22 (100)011 (100)0 (0)
Total20417 (8)107 (53)2553 (1)19 (8)



Conclusions: The prevalence of hrHPV detection in abnormal vaginal Pap tests reporting ASC-US, ASC-H, LSIL and HSIL results are similar to those reported in abnormal cervical Pap test specimens from older women.
Histopathologic diagnoses of VAIN1 and VAIN2/3 were significantly increased following hrHPV positive abnormal vaginal Pap tests when compared to follow-up findings for patients with hrHPV negative abnormal vaginal Pap tests.
Reflex hrHPV DNA testing is a useful tool for assessing risk of histopathologic VAIN and in considering follow-up management options for women with abnormal vaginal Pap test results.
Category: Gynecologic & Obstetrics

Tuesday, March 1, 2011 9:30 AM

Poster Session III # 209, Tuesday Morning

 

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