Follow‐up with histopathology and HPV testing on LSIL cytology in China’s largest academic woman’s hospital

Abstract

Background Cervical cancer remains a major health problem in China. To provide baseline data for establishing the appropriate screening strategy, the authors investigated the histopathologic follow‐up and human papillomavirus (HPV) testing results of low‐grade squamous intraepithelial lesion (LSIL) cytology in the Chinese Largest Women Hospital. Methods Women with LSIL cytology, human papillomavirus (HPV) testing, and immediate histopathologic follow‐up between 2011 and 2016 were analyzed. Results The frequency of LSIL among 1,095,022 Papanicolaou (Pap) tests was 1.4%, and was significantly higher in cases using liquid‐based cytology (LBC; 1.5%‐1.6%) compared with conventional Pap smears (CPS; 0.5%). The CPS method had performance for predicting cervical intraepithelial neoplasia (CIN) that was comparable to that of LBC (75% vs 69.1% and 71.9%). Among 8079 LSIL cases with an immediate histopathologic diagnosis, CIN‐2/3 or higher (CIN‐2/3+) was found in 11.9% of cases and carcinoma in 0.3% of cases. A total of 158 patients (15.7%) with HPV‐positive LSIL had a diagnosis of CIN‐2/3 compared with 18 patients (5.5%) with HPV‐negative LSIL. In postmenopausal women with LSIL cytology, the detection rate for CIN‐2/3 in HPV‐negative patients was significant lower than that in HPV‐positive patients. Furthermore, HPV type 16 (HPV‐16) was the most common genotype noted in patients with CIN‐2+ lesions, whereas HPV‐18 was the most common in patients with CIN‐1. Conclusions Although its reporting rate is lower than that of LBC, CPS is useful due to its low cost and comparable predictive value. HPV testing is helpful for stratifying postmenopausal women with LSIL into lower and higher risk groups. HPV‐16 is the most commonly identified genotype in CIN‐2+ lesions diagnosed in Chinese women with LSIL cytology, whereas HPV‐18 is the most commonly identified genotype in patients with CIN‐1 lesions.

Prevalence of HPV‐16/18 genotypes and immediate histopathologic correlation results in a Chinese population with negative cytology and positive high‐risk HPV testing

“…The current study has demonstrated a similar result: conventional Pap testing has a comparable reporting rate and a slightly lower predicative value for predicting CIN‐2+ among the 3 preparation methods in the NILM group (reporting rate, 97.8% vs 94.2% for ThinPrep and 92.9% for SurePath; rate for predicting CIN‐2+, 1.4% vs 2.1% for ThinPrep and 2.1% for SurePath). These results also support the notion from our previous study that conventional Pap testing still remains a reasonable option in rural areas of China because of the limited resources, low cost, ease of setup, and relatively comparable performance …”

“…In a recent study, we found that the conventional Pap preparation method has performance comparable to that of liquid‐based cytology for predicting CIN in Chinese women with low‐grade squamous intraepithelial lesion cytology. The current study has demonstrated a similar result: conventional Pap testing has a comparable reporting rate and a slightly lower predicative value for predicting CIN‐2+ among the 3 preparation methods in the NILM group (reporting rate, 97.8% vs 94.2% for ThinPrep and 92.9% for SurePath; rate for predicting CIN‐2+, 1.4% vs 2.1% for ThinPrep and 2.1% for SurePath).…”

Atypical squamous cells of undetermined significance cervical cytology in the Chinese population: Age‐stratified reporting rates, high‐risk HPV testing, and immediate histologic correlation results

“…These results are essentially in agreement with studies from Western countries and the benchmark ranges from the 2010 CAP survey in the United States 2 . In our previous studies, we observed that the CPT had performance comparable to that of liquid‐based cytology for predicting CIN2+ lesions in Chinese women who had negative cytology or low‐grade squamous intraepithelial lesion cytology 10,11 . The current study demonstrated that, although the CPT preparation method had the lowest reporting rate among the 3 methods, the performance of the CPT method for predicting CIN was comparable to the performance of the ThinPrep and SurePath methods (35.5% vs 35.9% and 32.1%, respectively).…”

“…The current study demonstrated that, although the CPT preparation method had the lowest reporting rate among the 3 methods, the performance of the CPT method for predicting CIN was comparable to the performance of the ThinPrep and SurePath methods (35.5% vs 35.9% and 32.1%, respectively). Similar to the observation from our earlier study, 10 the predictive value for detecting CIN2+ lesions was highest using the CPT method (12.0% vs 8.2% [ThinPrep] and 6.7% [SurePath]). These findings provide additional evidence that conventional Pap testing remains a reasonable option for Chinese women in the rural areas when the liquid preparation methods or HPV testing are not feasible, although at the cost of low sensitivity.…”

“…We previously published a series of investigations on the reporting rates, HPV testing results, and immediate histologic follow‐up data in Chinese women with different cytology diagnosis categories, including negative cytology, low‐grade squamous intraepithelial lesion, and high‐grade squamous intraepithelial lesion at OGHFU 9‐11 . Herein, we report our experience with ASC‐US cytology, the most common cytologic abnormality in cervical Pap tests, to provide baseline information for establishing the appropriate clinical management of cervical cancer screening for the Chinese population.…”