Previous cervical cytology and high-risk human papillomavirus testing in a cohort of patients with invasive cervical carcinoma in Shandong Province, China

Abstract

BackgroundCurrently, available data regarding previous cervical cytology and high-risk human papillomavirus (hrHPV) test results to detect invasive cervical cancer are limited and controversial in China. Therefore, this retrospective study in a population of Chinese women with invasive cervical carcinoma aimed to gain further insight into the roles of cytology and hrHPV testing in cervical cancer screening.MethodsA total of 1214 cases with a histological diagnosis of invasive cervical cancer were retrieved from the Pathology Database of Jinan KingMed Diagnostics (JKD) over a 5-year period. Previous cytology and hrHPV test results of 469 patients carried out within the year before cancer diagnosis were documented.ResultsA higher percentage of patients who had undergone prior screening had micro-invasive cervical carcinoma than patients who had no prior screening (25.4% vs. 12.1%, P < 0.001). Of the 469 patients with available prior screening results, 170 had cytology alone, 161 had hrHPV testing alone, and 138 had both cytology and hrHPV testing. There was a significantly lower percentage of hrHPV-positive cases with adenocarcinoma than with squamous cell carcinoma (77.8% vs. 96.4%, P = 0.001). The hrHPV test showed a significantly higher sensitivity than cytology alone (94.4% vs. 85.3%, P = 0.006). The overall sensitivity of the combination of cytology and hrHPV testing (98.6%) was much higher than that of cytology alone (P < 0.001) but only marginally higher than that of hrHPV testing alone (P = 0.058).ConclusionsThe results revealed that prior cervical screening can detect a significantly larger number of micro-invasive cervical cancers. The hrHPV test can provide a more sensitive and efficient strategy than cytology alone. As the addition of cytology to hrHPV testing can only marginally increase the efficiency of the hrHPV test, hrHPV testing should be used as the primary screening approach, especially in the low-resource settings of China.

Role of genomic DNA methylation in detection of cytologic and histologic abnormalities in high risk HPV-infected women

“…Recently, the co-testing of cytology and hrHPV detection has been increasingly used for cervical cancer screening [34, 35]. In this present study, there were 115 cases undergoing colposcopic examination following both cytologic abnormality and hrHPV-positivity.…”

HPV prevalence and genotype distribution among women in Shandong Province, China: Analysis of 94,489 HPV genotyping results from Shandong’s largest independent pathology laboratory

“…This multiplex PCR technique can detect 14 hrHPV genotypes (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) and 9 lr-/urHPV genotypes (6, 11, 42, 43, 53, 73, 81, 82, and 83). As reported previously [30–32], HPV DNA was amplified by the mixture of GP5+/GP6+ consensus and type-specific primers after extraction from the specimens. The PCR cycling conditions were as follows: initial denaturation at 95°C for 5 min, then 40 cycles at 94°C for 30 s, 42°C for 90 s, 72°C for 30 s, and a final extension at 72°C for 5 min [31, 32].…”

Outcomes of prior cervical cytology and HR-HPV testing in women subsequently diagnosed with CIN1, CIN2/3, and invasive cervical cancer: a 4-year routine clinical experience after implementation of systematic training and quality control programs

“…LBC preparation was carried out strictly in accordance with the manufacturers' instructions [9,27,28]. All cytological examinations were reported using the terminology of the 2001 Bethesda System.…”

“…Nearly 200,000 samples are tested for HPV every year in the JKD laboratory. In this study, all HR-HPV tests were carried out in the standardized molecular laboratory of JKD by using one of two methods: Hybrid Capture 2 (HC2; Qiagen, Hinden, Germany) and HPV genotyping (Yanengbio, Shenzhen, China) [27][28][29]. The HC2 assay is an in vitro nucleic acid hybridization method, which can semiquantitatively test for 13 HR-HPV genotypes (i.e., 16,18,31,33,35,39,45,51,52,56,58,59, and 68).…”