Clinical Significance of High Risk Human Papillomavirus (hrHPV) DNA Testing in Women with a Cytological Diagnosis of Atypical Glandular Cells
Akosua B Domfeh, Angelique Levi, Kevin Schofield, David Chhieng. Yale University, New Haven, CT
Background: Although the casual link between HPV and endocervical adenocarcinoma and its precursors is well established, the role of hrHPV DNA testing as a triage tool for atypical glandular cells (AGC) is still not clearly defined. The objective of this study is to determine if hrHPV testing contributed towards defining histological abnormalities in women with AGC according to preparation types and age groups.
Design: All liquid based Pap tests with the diagnosis of AGC between January 2008 and March 2012 were identified. Patient demographic information, results of hrHPV DNA testing, and subsequent histological follow-up were obtained from our laboratory information system. HrHPV DNA testing was performed using Hybrid Capture II (Qiagen, Gaithersburg MD). Results of histology follow up were divided into 3 groups: Group A: Negative or CIN I; Group B: CIN2+, endocervical adenocarcinoma and AIS; and Group C: endometrial hyperplasia and carcinoma.
Results: A total of 527 Pap tests were diagnosed with AGCs on Pap tests, which account for 0.16% all Pap tests evaluated during the study period. AGC diagnoses accounted for 0.15% of SurePath and 0.19% of ThinPrep; and the difference was not statistically significant. HrHPV status was available in 344 (65.3%) Pap tests; 91 (26.5%) were positive for hrHPV. Tables 1 and 2 summarizes the results of follow-up according to hrHPV status, preparation types, and different age groups (<40 and ≥ 40).