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.
|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|
|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|