Punch biopsy guided by both colposcopy and HR-HPV status is more efficient for identification of immediate high-grade squamous intraepithelial lesion or worse among HPV-infected women with atypical squamous cells of undetermined significance

被引:4
作者
Ding, Z. [1 ,2 ]
Li, Y. [3 ]
Chen, A. [2 ]
Song, M. [4 ]
Zhang, Y. [1 ]
机构
[1] Shandong Univ, Qilu Hosp, Jinan, Shandong, Peoples R China
[2] Qingdao Univ, Affiliated Hosp, Qingdao, Shandong, Peoples R China
[3] Second Peoples Hosp Liao Cheng, Liao Cheng, Shandong, Peoples R China
[4] Qingdao Tumour Hosp, Qingdao, Shandong, Peoples R China
关键词
Atypical squamous cells of undetermined significance; Colposcopy; HPV viral load; HPV genotype; High-grade squamous intraepithelial lesion; INVASIVE CERVICAL-CANCER; INTERNATIONAL INCIDENCE RATES; HUMAN-PAPILLOMAVIRUS; VIRAL LOAD; RISK; NEOPLASIA; TRIAGE;
D O I
10.1016/j.ejogrb.2016.10.005
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objectives: To investigate the accuracy of colposcopy for diagnosing high-grade squamous intraepithelial lesion (HSIL) or worse (HSIL+) in human papillomavirus (HPV)-infected patients with atypical squamous cells of undetermined significance (ASCUS) cytology, and determine whether genotyping and viral load quantitation can be useful for detecting immediate HSIL+ risk in these patients. Study design: This study included 620 cases with ASCUS and positive for high-risk (HR)-HPV within 1 month before or after cervical cytology at Qilu Hospital between February 2013 and February 2014. Based on the colposcopic impression, lesion-targeted punch biopsy, endocervical curettage biopsy or random cervical punch biopsy in four quadrants was performed on these patients within 1 month. The accuracy of colposcopy for diagnosing HSIL+ was evaluated through comparison with the biopsy results. HR-HPV status determined by Hybrid Capture 2 or HPV genotyping was analysed retrospectively as a possible predictor of HSIL+. Results: Agreement between colposcopic impression and cervical pathology was matched perfectly in 89.2% of cases (553/620), and the strength of agreement with the K statistic was 0.698 (p <0.001). Colposcopy had high specificity (96.9%) but low sensitivity for detecting HSIL+ (67.5%). The risk of HSIL+ was significantly higher in patients with HPV-16 infection (52.3%) than in patients infected with other types of HPV (17.9%, p < 0.001). HSIL+ and virus load was correlated at cut-offs (CO) of 50 relative light units (RLU)/CO and 100 RLU/CO (p = 0.024 and 0.044, respectively). If considering HPV16 infection or high virus load (at 50 RLU/CO) as a diagnostic standard of HSIL+ when colposcopic impression was negative, sensitivity was improved to 74.7% and 81.0%, respectively. Conclusions: Good agreement was found between colposcopic and pathologic diagnosis. HR-HPV genotyping or virus load is relevant to the detection of HSIL+ among HPV-infected patients with ASCUS cytology. In these patients, biopsies considering HPV-16 infection or virus load >= 50 RLU/CO may be helpful for increasing the HSIL+ detection rate. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:32 / 36
页数:5
相关论文
共 31 条
[1]   Human papillomavirus testing versus repeat cytology for triage of minor cytological cervical lesions [J].
Arbyn, Marc ;
Roelens, Jolien ;
Simoens, Cindy ;
Buntinx, Frank ;
Paraskevaidis, Evangelos ;
Martin-Hirsch, Pierre P. L. ;
Prendiville, Walter J. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2013, (03)
[2]   Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study [J].
de Sanjose, Silvia ;
Quint, Wim G. V. ;
Alemany, Laia ;
Geraets, Daan T. ;
Ellen Klaustermeier, Jo ;
Lloveras, Belen ;
Tous, Sara ;
Felix, Ana ;
Eduardo Bravo, Luis ;
Shin, Hai-Rim ;
Vallejos, Carlos S. ;
Alonso de Ruiz, Patricia ;
Lima, Marcus Aurelho ;
Guimera, Nuria ;
Clavero, Omar ;
Alejo, Maria ;
Llombart-Bosch, Antonio ;
Cheng-Yang, Chou ;
Alejandro Tatti, Silvio ;
Kasamatsu, Elena ;
Iljazovic, Ermina ;
Odida, Michael ;
Prado, Rodrigo ;
Seoud, Muhieddine ;
Grce, Magdalena ;
Usubutun, Alp ;
Jain, Asha ;
Hernandez Suarez, Gustavo Adolfo ;
Estuardo Lombardi, Luis ;
Banjo, Aekunbiola ;
Menendez, Clara ;
Javier Domingo, Efren ;
Velasco, Julio ;
Nessa, Ashrafun ;
Chichareon, Saibua C. Bunnag ;
Qiao, You Lin ;
Lerma, Enrique ;
Garland, Suzanne M. ;
Sasagawa, Toshiyuki ;
Ferrera, Annabelle ;
Hammouda, Doudja ;
Mariani, Luciano ;
Pelayo, Adela ;
Steiner, Ivo ;
Oliva, Esther ;
Meijer, Chris J. L. M. ;
Al-Jassar, Waleed Fahad ;
Cruz, Eugenia ;
Wright, Thomas C. ;
Puras, Ana .
LANCET ONCOLOGY, 2010, 11 (11) :1048-1056
[3]  
Di Stefano L, 2014, EUR J GYNAECOL ONCOL, V35, P16
[4]   Contribution of Exocervical Biopsy, Endocervical Curettage, and Colposcopic Grading in Diagnosing High-Grade Cervical Intraepithelial Neoplasia [J].
Diedrich, Justin Thomas ;
Felix, Juan C. ;
Lonky, Neal M. .
JOURNAL OF LOWER GENITAL TRACT DISEASE, 2016, 20 (01) :52-56
[5]   Study of accuracy of colposcopy in VIA and HPV detection-based cervical cancer screening program [J].
Ghosh, Ishita ;
Mittal, Srabani ;
Banerjee, Dipanwita ;
Singh, Priyanka ;
Dasgupta, Sujoy ;
Chatterjee, Simi ;
Biswas, Jaydip ;
Panda, Chinmay ;
Basu, Partha .
AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY, 2014, 54 (06) :570-575
[6]   International incidence rates of invasive cervical cancer after introduction of cytological screening [J].
Gustafsson, L ;
Ponten, J ;
Zack, M ;
Adami, HO .
CANCER CAUSES & CONTROL, 1997, 8 (05) :755-763
[7]  
Gustafsson L, 1997, INT J CANCER, V71, P159, DOI 10.1002/(SICI)1097-0215(19970410)71:2<159::AID-IJC6>3.0.CO
[8]  
2-#
[9]   European guidelines for quality assurance in cervical cancer screening: recommendations for cervical cytology terminology [J].
Herbert, A. ;
Bergeron, C. ;
Wiener, H. ;
Schenck, U. ;
Klinkhamer, P. ;
Bulten, J. ;
Arbyn, M. .
CYTOPATHOLOGY, 2007, 18 (04) :213-219
[10]   A Weakly Positive Human Papillomavirus Hybrid Capture II Result Correlates With a Significantly Lower Risk of Cervical Intraepithelial Neoplasia 2,3 After Atypical Squamous Cells of Undetermined Significance Cytology [J].
Jarboe, Elke A. ;
Venkat, Pavithra ;
Hirsch, Michelle S. ;
Cibas, Edmund S. ;
Crum, Christopher P. ;
Garner, Elizabeth I. O. .
JOURNAL OF LOWER GENITAL TRACT DISEASE, 2010, 14 (03) :174-178