Do Infection Patterns of Human Papillomavirus Affect the Cytologic Detection of High-Grade Cervical Lesions on Papanicolaou Tests?

Context.--Persistent infection with high-risk human papillomavirus (hrHPV) is the major cause of cervical cancer. The effect of HPV infection patterns on cytologic detection of cervical lesions is unknown. Objective.--To determine the effect of HPV infection patterns on the sensitivity of cytologic...

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Publicado en:Archives of Pathology & Laboratory Medicine Vol. 142; no. 3; pp. 347 - 353
Autores principales: Samimi, Siavash Azadmanesh, Mody, Roxanne R., Goodman, Steven, Luna, Eric, Armylagos, Donna, Schwartz, Mary R., Mody, Dina R., Yimin Ge
Formato: research tables/charts Journal Article
Publicado: College of American Pathologists Mar2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2018
      vid: 142
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      pub: College of American Pathologists
      place: Northfield, Illinois
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        10.5858/arpa.2016-0478-OA
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        atl: Do Infection Patterns of Human Papillomavirus Affect the Cytologic Detection of High-Grade Cervical Lesions on Papanicolaou Tests?
      aug:
        au:
          Samimi, Siavash Azadmanesh
          Mody, Roxanne R.
          Goodman, Steven
          Luna, Eric
          Armylagos, Donna
          Schwartz, Mary R.
          Mody, Dina R.
          Yimin Ge
        affil: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
      sug:
        subj:
          Papillomavirus Infections
          Sensitivity and Specificity
          Cytological Techniques
          Cervix Neoplasms Diagnosis
          Neoplasm Grading
          Cervical Smears
          Human
          Female
          Neoplasms, Glandular and Epithelial
          Coinfection
          Genotype
          Female
      ab: Context.--Persistent infection with high-risk human papillomavirus (hrHPV) is the major cause of cervical cancer. The effect of HPV infection patterns on cytologic detection of cervical lesions is unknown. Objective.--To determine the effect of HPV infection patterns on the sensitivity of cytologic detection of highgrade cervical lesions. Design.--Papanicolaou tests from 257 women with biopsy-confirmed, high-grade squamous intraepithelial lesions were analyzed with respect to HPV infection patterns. Results.--Among 257 biopsy-confirmed, high-grade squamous intraepithelial lesion cases, the preceding cytology showed 20 cases (8%) were benign; 166 cases (65%) were low-grade cervical lesions, including atypical squamous cell of undetermined significance and low-grade squamous intraepithelial lesions; and 71 cases (28%) were high-grade cervical lesions, including atypical squamous cells cannot rule out high-grade squamous intraepithelial lesion (atypical squamous cell-high), atypical glandular cells, and high-grade squamous intraepithelial lesions. In 236 cases tested for HPV, those exhibiting low-grade cervical lesions on cytology were often associated with coinfections of mixed hrHPv genotypes (31 of 40; 78%) or non-16/18 hrHPV (75/103; 73%), compared with single-genotype infections of HPV-16 (33 of 62; 53%) or HPV-18 (2 of 6; 33%) (P = .001). In contrast, highgrade cervical lesion cytomorphology tended to associate with the single-genotype infection of HPV-16 (20 of 62; 32%) or HPV-18 (3 of 6; 50%), compared with non-16/18 hrHPV (25 of 103; 24%) or multigenotype infection (8 of 40; 20%) (P = .01). Conclusions.--Our findings suggest that multigenotypic or non-16/18 hrHPV infections often produce deceptive lower-grade cytomorphology, which could result in underdiagnosis and delay of treatment. The HPV infection patterns may offer unrecognized benefit beyond HPV genotyping and should be considered during clinical risk evaluation of women with lower-grade cytology.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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