[996] Cytology and hrHPV Test Results Associated with 717 Histopathologic Diagnoses of CIN2/3 at a Large Academic Womens' Hospital.

Milon Amin, Xiangbai Chen, Robert Marshall Austin, Chengquan Zhao. Magee-Womens Hospital (MWH) of University of Pittsburgh Medical Center (UPMC), PA; Conemaugh Memorial Hospital, Johnstown, PA

Background: Widely cited studies reflecting use of conventional Pap smears have emphasized the significance of ASC-US Pap tests preceding histopathologic diagnoses of CIN2/3. Data reflecting current widespread U.S. use of liquid-based cytology (LBC), computer-assisted screening, and adjunctive HPV testing remain limited.
Design: A computer-based search was performed for a study period between July 2008 and July 2010 to identify surgical pathology cases reported as cervical CIN2/3 in the CoPath database of a large womens' hospital practice. Previous computer-imaged LBC ThinPrep Pap (TPPT) and hrHPV (Hybrid Capture 2) test results were recorded.
Results: 717 cases of histopathologic CIN2/3 diagnoses were identified, including 600 patients with LEEP/cone biopsies and 42 with subsequent hysterectomies. The average patient age was 33 years with a range of 17 to 91 years. 208 cases (29%) showed no reasons for cervical biopsy in our files. The abnormal Pap test results which led to histopathologic diagnoses of CIN2/3 were available for 509 (71%) women. Of these particular Pap test results, 99 were ASC-US, 66 were ASC-H, 82 were LSIL, 256 were HSIL and 6 were AGC. 314 of 717 CIN2/3 diagnoses had available prior Pap test results (Table 1). Available prior HPV test results are listed in Table 2.

Table 1. Test History Prior to Abnormal Pap Results and Histopathologic CIN2/3 Diagnoses*

Results (prior 3 years)	#Cases	%
At least one abnormal smear	210	66.9
At least one normal smear	184	58.6
Both normal and abnormal smears	80	25.5
Total number of patients	314	100

* The abnormal Pap tests which triggered the surgical procedures are not included.

Table 2. HPV test results of patients with Histopathologic CIN2/3 Diagnoses

	#Cases	#Positive Cases	%
HPV testing immediately before CIN2/3 diagnoses	207	204	98.6
HPV test results in prior 3 years (not including above)	91	75	82.4

Conclusions: LBC Pap test results of HSIL were associated with 50% of 508 histopathologic CIN2/3 diagnoses, followed by ASC-US in 19%, LSIL in 16%, and ASC-H in 13%. Over a three year period preceding CIN2/3 diagnoses, a significant number of isolated negative Pap (58.6%) or negative HPV test (17.6%) results were noted, supporting the value of combined cytologic and HPV co-testing.
Category: Gynecologic & Obstetrics

Tuesday, March 1, 2011 9:30 AM

Poster Session III # 206, Tuesday Morning