Banghyun Lee1, Dong Hoon Suh2, Kidong Kim3, Jae Hong No2, Yong-Beom Kim2. 1. Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea. 2. Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea Seoul National University, School of Medicine, Seoul, Republic of Korea. 3. Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea Seoul National University, School of Medicine, Seoul, Republic of Korea kidong.kim.md@gmail.com.
Abstract
BACKGROUND/AIM: No human papillomavirus (HPV) type-specific guidelines exist for managing cases of patients with atypical squamous cells of undetermined significance (ASC-US) by cervical cytology. Herein, we investigated ASC-US triage strategies using HPV genotyping to identify methods that are potentially superior to triage, using Hybrid Capture 2. MATERIALS AND METHODS: In this retrospective cohort study, 144 Korean women with ASC-US cytology underwent HPV genotyping and punch biopsy under colposcopy/endocervical curettage. We created a model for ASC-US triage using HPV genotyping in these patients. The sensitivity of the final triage criterion was internally validated using bootstrapping. RESULTS: Positivity for HPV16, 18, 31, 33, 52 and 58 genotype corresponded to a referral rate of 63% and detection of 92% of cases of cervical intraepithelial neoplasia grade 2 or higher. The referral and detection rates for such cases increased in proportion to the number of high-risk HPV types. The sensitivity of genotyping for HPV16, 18, 31, 33, 52 and 58 was 92%. CONCLUSION: The study demonstrates that HPV genotyping of specific HR-HPV types may be an effective strategy in ASC-US triage and may replace conventional HPV tests. Copyright
BACKGROUND/AIM: No human papillomavirus (HPV) type-specific guidelines exist for managing cases of patients with atypical squamous cells of undetermined significance (ASC-US) by cervical cytology. Herein, we investigated ASC-US triage strategies using HPV genotyping to identify methods that are potentially superior to triage, using Hybrid Capture 2. MATERIALS AND METHODS: In this retrospective cohort study, 144 Korean women with ASC-US cytology underwent HPV genotyping and punch biopsy under colposcopy/endocervical curettage. We created a model for ASC-US triage using HPV genotyping in these patients. The sensitivity of the final triage criterion was internally validated using bootstrapping. RESULTS: Positivity for HPV16, 18, 31, 33, 52 and 58 genotype corresponded to a referral rate of 63% and detection of 92% of cases of cervical intraepithelial neoplasia grade 2 or higher. The referral and detection rates for such cases increased in proportion to the number of high-risk HPV types. The sensitivity of genotyping for HPV16, 18, 31, 33, 52 and 58 was 92%. CONCLUSION: The study demonstrates that HPV genotyping of specific HR-HPV types may be an effective strategy in ASC-US triage and may replace conventional HPV tests. Copyright