HPV test results and histological follow-up results of patients with LSIL Cervical Cytology from the Largest CAP-certified laboratory in China

Abstract

Background: Age-adjusted evaluations have explored the possible utility of (HPV test results in women with LSIL Pap. We investigated HPV test results and histopathologic follow-up results of LSIL patients from China's largest CAP-certified laboratory.Methods: Patients with LSIL between 2011 and 2015 from the Guangzhou Kingmed Diagnostics were retrospectively retrieved and their hrHPV test results and histological follow-up results were collected and analyzed.Results: LSIL result was identified in 37,895 cases from 2,206,588 Pap tests (1.7%) including 1,513,265 liquid-based cytology and 693,323 conventional Pap tests. The average of these women was 38.4 years (15-88). The LSIL reporting rate in women <30 years was significantly higher than that in women > 30 years (2.1% vs 1.7%). The age specific reporting LSIL rates declined with increased age. 8,014 of 37,895 (21.2%) women with LSIL cytology also had HC2 HPV test results. 75.8% of women with LSIL Pap tests were hrHPV+ and the HPV+ rates declined with increased age except in patients older than 60 years. Overall histopathologic diagnoses within 6 months after LSIL were identified in 5,987 of 37,895 patients at Guangzhou Kingmed Diagnostics. CIN2/3 was identified in 15.2% patients, CIN1 in 66.9%, negative in 14.9% patients. No invasive carcinoma was found in all patients. Of 8014 patients with LSIL Pap test and HPV testing results, 1727 patients had histological follow-up within 6 months after Pap cytology test and HPV testing. The detection rate of CIN2/3 was significantly higher in patients with positive HPV testing result than that in patients with negative HPV testing result (17.8% vs. 8.1%). Among patients with LSIL/HPV negative tests, CIN2/3 was detected in 1 of 30 (3.3%) women aged 50 years and above, appearing lower than those in women less than 50 years (8.0%, 28/351, P=0.357).Conclusion: This is the largest histological follow-up study in women with LSIL Pap from China and the data are helpful in establishing a baseline for better understanding the status of cervical screening in China. The 85.1% positive predict value of LSIL Pap cytology for follow-up CIN lesion was within currently recognized benchmark ranges.

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

“…There was no significant difference noted with regard to the detection rates among the 3 testing platforms. This result is very similar to those reported in another large study in a Chinese population (75.8%), a large pooled meta‐analysis (76%), and what to the best of our knowledge is the largest study performed in an American population from the University of Pittsburgh Medical Center (74.1%) . It is interesting to note that the hrHPV‐positive rate was the second highest in women in the current study population aged 60 to 69 years (80.0%), which is higher than those in all other age groups except patients aged <20 years.…”

“…In the current study, the predictive value of LSIL Pap cytology for follow-up CIN lesions was 70.2% (5673 of 8079 cases) and was slightly lower than the positive predictive value of 85.1% previously reported in another similar study in the Chinese population, 14 but still was within the currently recognized benchmark ranges for international cytology laboratories. Although conventional cytology has been replaced by LBC testing as the primary test method in the majority of developed countries within the last 10 to 15 years, it remains an option for women in China.…”

“…In a previous large study in the Chinese population, it also was reported that the hrHPV-positive rate in patients aged ≥60 years with LSIL cytology was 77.2%, which is higher than that noted in patients aged 30 to 59 years. 14 The hrHPV positive peak found to be present in older women also was reported in studies from China and a few other populations. 8,[26][27][28] The hypotheses for this phenomenon include age-related or menopause-related changes in the cervicovaginal epithelium, changes in sexual behavior during middle age, and age-related immune senescence leading to increased reactivation of latent infections.…”

“…It is interesting to note that the hrHPV‐positive rate was the second highest in women in the current study population aged 60 to 69 years (80.0%), which is higher than those in all other age groups except patients aged <20 years. In a previous large study in the Chinese population, it also was reported that the hrHPV‐positive rate in patients aged ≥60 years with LSIL cytology was 77.2%, which is higher than that noted in patients aged 30 to 59 years . The hrHPV positive peak found to be present in older women also was reported in studies from China and a few other populations .…”

Risikobewertung von Zytologiebefunden im Zervixkarzinom-Screening

“…Die Kaplan-Meier-Schätzung zeigt, dass eine zytologische Differenzierung von 3 Schweregraden bei sig- [29]. Dass LSIL-Patientinnen ein Niedrigrisikokollektiv für ein Zervixkarzinom darstellen, hatte zudem 2016 eine schwedische Follow-up-Studie mit Beobachtungszeiten von mehr als 10 Jahren anhand großer Zahlen nachgewiesen [28]: In nur 0,5 % fanden sich Karzinome.…”