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

Abstract

Background The objective of this study was to examine the prevalence of human papillomavirus 16/18 (HPV‐16/18) genotypes and immediate histopathologic correlations in a Chinese population with negative cytology and positive high‐risk human papillomavirus (hrHPV) testing. Methods Patients who had documented negative cytology with immediate follow‐up (within the 6 months after negative for intraepithelial lesion or malignancy Papanicolaou [Pap] testing), including a histopathologic examination and/or hrHPV testing, between 2011 and 2018 were included, and the data were analyzed. Results Among 1,424,182 Pap tests, 1,333,453 (93.6%) were interpreted as negative cytology. Although conventional Pap smears had the highest reporting rate, cervical intraepithelial neoplasia 2 and higher (CIN‐2+) lesions were detected significantly more with liquid‐based cytology preparations (2.1%) than the conventional method (1.4%; P < .01). The overall hrHPV‐positive rate was 14.9% (25,507 of 171,273) in the women with negative cytology. Among the 18,423 cytology‐negative, HPV‐positive cases tested with the Cobas assay, the overall HPV‐16/18 prevalence was 24.7%, with 17.9% being HPV‐16–positive, 6.2% being HPV‐18–positive, and 0.6% being positive for both HPV‐16 and HPV‐18. The immediate histopathologic examination was documented for 21,796 women with cotesting results, including 8915 HPV‐positive cases and 12,881 HPV‐negative cases. CIN‐2+ lesions were diagnosed in 15.2% of the HPV‐16–positive cases; this rate was significantly higher than the rates seen in the HPV‐18–positive cases (4.8%) and the cases positive for 1 of the other 12 types of HPV (3.0%). Conclusions This is by far the largest routine clinical practice report of HPV‐16/18 genotyping and histopathologic examination in negative‐cytology women and the first report of such an investigation in the Chinese population. This study indicates enhanced risk stratification with HPV‐16/18 genotype testing in HPV‐positive, cytology‐negative women in the Chinese population.

Is cervical cytology testing as a part of co‐test unnecessary for HPV 16/18‐infected women? A retrospective cohort study of 1647 women

“…Han et al 20 found that one (1.6%) of 64 HPV‐infected patients with negative cytology had adenocarcinoma, two (3.1%) patients had adenocarcinoma in situ, and three (4.7%) patients had CIN 2/3. In a study of 1427 HPV 16‐infected women with negative cytology, Tao et al 21 demonstrated that the rate of CIN 2+ lesion was 15.2% and similar to our results. Wu et al 22 demonstrated that the risk of developing CIN 3+ lesion was significantly lower in HPV16 + other hrHPVs group compared with single HPV16 infection (OR, 0.637; 95%CI, 0.493‐0.822).…”

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).…”

“…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.…”

HPV Genotype Specific and Age Stratified Immediate Prevalence of Cervical Precancers and Cancers in Women with NILM/hrHPV+: A Single Center Retrospective Study of 26,228 Cases

“…A study by Han et al 22 33 In another retrospective study, the results from the Cobas assay demonstrated a slightly lower HPV-16 and/or HPV-18 prevalence in Chinese women with NILM/hrHPV+ (17.6% for HPV-16, 6.2% for HPV-18, and 0.6% for HPV-16 and HPV-18) than in Korean women. 34 The distribution of HPV genotypes in women with NILM/hrHPV+ differs among countries; this may be attributed to different subtypes of HPV infection in different races and regions, and the different detection platforms. 35 As mentioned earlier, the mRNA-based AHPV assay has been found to be more specific in detecting high-grade cervical lesions.…”