[436] Age-Specific HPV, High-Risk HPV and HPV16/18 Rates and Follow-Up Histologic Diagnoses in Women with Atypical Squamous Cells of Undetermined Significance (ASC-US). A Study of 17,059 Cases from a Predominantly Low-Risk Screening Population.

Charanjeet Singh, Roberto G Gamez, Bharat Thyagarajan, Jana Holler, Evin H Gulbahce, Stefan E Pambuccian. University of Minnesota, Minneapolis

Background: ASC-US is the most frequent abnormal diagnosis made on Pap tests and the most frequent cytologic diagnosis leading to the diagnosis of clinically significant cervical precursor lesions (CIN 2/3).
The aim of this study was to review our experience with HPV reflex testing and genotyping and follow-up CIN2/3 diagnoses of women with ASC-US from a predominantly low-risk, suburban screening population
Design: All cases diagnosed as ASC-US according to the 2001 Bethesda System with a HPV test performed by PCR from 12/3/2003 to 6/30 2009 were entered into a spreadsheet together with the age of the patient, HPV type and follow-up biopsy diagnoses within 6 months. Any HPV+, high-risk HPV+ (HPV types included in the hc2 cocktail), HPV16/18+ and follow-up diagnoses of CIN2/3 were then compared.
Results:

Age<2020-2930-3940-4950-59>60Number of cases of ASC-US (% of total ASC-US)
Total ASC-US1182565637023990178474517059
Any HPV type (% of all ASC-US)720 (60.9%)3054 (54.0%)1303 (35.2%)798 (20.0%)427 (23.9%)196 (26.3%)6498 (38.1%)
HR-HPV (% of all ASC-US)377 (31.9%)1488 (26.3%)594 (16.1%)301 (7.5%)118 (6.6%)62 (8.3%)2940 (17.2%)
HR-HPV (% of all HPV+ASC-US)377 (52.4%)1488 (48.7%)594 (45.5%)301 (37.7%)118 (27.6%)62 (31.6%) 
HPV16/18 (% of all ASC-US)200 (16.9%)836 (14.8%)287 (7.8%)122 (3.1%)41 (2.3%)24 (3.2%)1510 (8.9%)
HPV 16/18 (% of all HPV+ASC-US)200 (27.7%)836 (27.3%)287 (22.0%)122 (15.2%)41 (9.6%)24 (12.24%) 
Biopsies (% biopsied)242 (20.4%)1391 (24.4%)760 (20.5%)564 (14.1%)268 (15.0%)93 (12.48%)3318 (19.45%)
CIN2/3 (% of all ASC-US)59(4.9%)242(4.2%)97(2.60%)44(1.1%)11(0.6%)3 (0.4%)456 (2.7%)
CIN 2/3 (% of all biopsies)59(24.4%)242(17.4%)97(12.8%)44(7.8%)11(4.1%)3 (3.2%) 
Risk of CIN2/3 in HPV16/18+ ASC-US33 (42.9%)129 (31.5%)40 (26.3%)13 (21.3%)3 (12.0%)1 (12.5%) 
Odds of CIN2/3 HPV16/18+ASC-US vs. non-16/18-HRHPV+ASC-US4.03.53.44.14.04.1 



Conclusions: With increasing age of women with ASC-US, there is a steady decline in the percentage all HPV+, HR-HPV+ and HPV 16/18+ ASC-US, and CIN2/3 lesions. Genotyping for HPV16/18, however, still retains its value since across all age groups HPV16/18 have 4x more odds of CIN2/3 lesions on follow-up compared to all other HR-HPV.
Category: Cytopathology

Monday, February 28, 2011 9:30 AM

Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 60, Monday Morning

 

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