Olga Veijalainen1, Sanna Tuomisaari2, Tiina Luukkaala2,3, Johanna Mäenpää1,4. 1. Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland. 2. Science Center, Pirkanmaa Hospital District, Tampere, Finland. 3. School of Health Sciences, University of Tampere, Tampere, Finland. 4. School of Medicine, University of Tampere, Tampere, Finland.
Abstract
INTRODUCTION: The purpose of this study was to evaluate the real-life performance of high-risk (HR) HPV testing in the triage of repeat atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesions (LSIL). MATERIAL AND METHODS: In 2004-2012, 127 women with repeat ASC-US and 118 women with LSIL were triaged with HPV testing using either a Hybrid Capture 2(®) or Abbott RealTime(®) HR-HPV test. The patient charts were retrospectively reviewed for performance of the tests. RESULTS: In the repeat ASC-US group, 40.9% of the women were positive for HR-HPV. The prevalence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was 8.7%. The sensitivity of the HR-HPV testing for detection of CIN2+ was 90.9% (95% Cl 58.7-98.5%), with a specificity of 63.8% (95%CI 54.4-72.5%). In women ≥30 years old, the specificity was 70.4%, whereas in younger women it was only 27.8%. The negative predictive value to predict CIN3 was 100% (95% CI 95.2-100.0%). Of the women with LSIL, 68.6% were positive for HR-HPV and the prevalence of CIN2+ was 14.4%. The sensitivity of HR-HPV testing for detection of CIN2+ was 94.1% (95% CI 71.2-99.0%), and the specificity 35.6% (95% CI 26.4-45.8%), respectively. The negative predictive value to predict CIN3 was 100% (95% CI 90.4-100.0%). CONCLUSION: HR-HPV testing seems to be beneficial in the triage of repeat ASC-US in women ≥30 years old, but a high prevalence of HR-HPV infection combined with poor specificity limit the use of HPV testing in the case of LSIL.
INTRODUCTION: The purpose of this study was to evaluate the real-life performance of high-risk (HR) HPV testing in the triage of repeat atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesions (LSIL). MATERIAL AND METHODS: In 2004-2012, 127 women with repeat ASC-US and 118 women with LSIL were triaged with HPV testing using either a Hybrid Capture 2(®) or Abbott RealTime(®) HR-HPV test. The patient charts were retrospectively reviewed for performance of the tests. RESULTS: In the repeat ASC-US group, 40.9% of the women were positive for HR-HPV. The prevalence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was 8.7%. The sensitivity of the HR-HPV testing for detection of CIN2+ was 90.9% (95% Cl 58.7-98.5%), with a specificity of 63.8% (95%CI 54.4-72.5%). In women ≥30 years old, the specificity was 70.4%, whereas in younger women it was only 27.8%. The negative predictive value to predict CIN3 was 100% (95% CI 95.2-100.0%). Of the women with LSIL, 68.6% were positive for HR-HPV and the prevalence of CIN2+ was 14.4%. The sensitivity of HR-HPV testing for detection of CIN2+ was 94.1% (95% CI 71.2-99.0%), and the specificity 35.6% (95% CI 26.4-45.8%), respectively. The negative predictive value to predict CIN3 was 100% (95% CI 90.4-100.0%). CONCLUSION:HR-HPV testing seems to be beneficial in the triage of repeat ASC-US in women ≥30 years old, but a high prevalence of HR-HPV infection combined with poor specificity limit the use of HPV testing in the case of LSIL.
Authors: Gaetano Riemma; Maria Teresa Schettino; Gaetano Maria Munno; Diego Domenico Fasulo; Lucia Sandullo; Emanuele Amabile; Marco La Verde; Marco Torella Journal: Medicina (Kaunas) Date: 2022-05-09 Impact factor: 2.948