Retrospective analysis of cervical cancer and precancerous lesions in patients with atypical squamous cells of undetermined significance in China

Wang, Yanying; Kong, Linghua; Liu, Yang; Shu, Wang; Fan, Qingbo; Zhu, Lan; Lang, Jinghe

doi:10.1097/md.0000000000018239

Cited by 4 publications

(9 citation statements)

References 22 publications

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“…The average hrHPV‐positive rate of 48.7% in women with ASC‐US cytology from our current study is within the ranges reported based on the studies from the United States and other Western countries 5,14 . Two recent studies from China reported a 34.98% of hrHPV positivity rate among women with ASC‐US in a large‐scale study 7 and 34.3% in a small study, 15 both tested using the HC2 assay. Our results demonstrated similar hrHPV positivity rates between the Cervista assay (57.8%) and the BioPerfectus assay (52.3%), which were significantly higher than the rates with HC2 (38.8%) and the Cobas 4800 assay (46.9%).…”

Section: Discussionsupporting

confidence: 84%

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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

Tao

Zhang

Wang

et al. 2020

Cancer Cytopathology

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Background The US American Society of Colposcopy and Cervical Pathology guidelines for cervical cancer screening have been largely adopted worldwide. Pooled high‐risk human papillomavirus (hrHPV) testing has been routinely used to risk‐stratify women who have atypical squamous cells of undetermined significance (ASC‐US) cytology. However, it has been reported that there are distinguished differences in the distribution of hrHPV genotypes between the Chinese and American populations. Methods The objective of this study was to analyze the age‐stratified reporting rates, hrHPV‐positive rates, and genotyping by different cytology preparation methods and hrHPV testing assays, along with the immediate histopathologic correlation of ASC‐US cytology, in the Chinese population. Results The ASC‐US reporting rate of 1,597,136 Papanicolaou (Pap) tests was 4.2%, and the overall hrHPV‐positive rate was 48.7% in the ASC‐US cases. In total, 25,338 women with ASC‐US Pap tests had immediate histologic follow‐up, and the detection rate for cervical intraepithelial neoplasia 2 and higher lesions (CIN2+) was 7.1%, including 0.6% carcinomas. Among the women who underwent hrHPV testing, CIN2+ lesions were identified in 657 of 6154 (10.7%) who had hrHPV‐positive results and in only 1.5% those who had hrHPV‐negative results. Further genotyping analysis revealed that HPV types 16 and/or 18 were commonly identified genotypes among the Chinese women who had ASC‐US cytology. Conclusions This large‐scale study demonstrated that the hrHPV‐positive rate, the CIN2+ detection rate, and the distribution of hrHPV genotypes in Chinese women with ASC‐US cytology were essentially consistent with those from the American population, further supporting that the current and newly released 2019 American Society of Colposcopy and Cervical Pathology guidelines should be applicable to the Chinese population.

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Section: Discussionsupporting

confidence: 84%

“…For example, HC2 and Cervista tests were used predominately in the earlier years, when the CPT method was still available. This also may explain the higher hrHPV‐positive rate in our study compared with the other 2 Chinese studies 7,15 …”

Section: Discussionmentioning

confidence: 53%

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

Tao

Zhang

Wang

et al. 2020

Cancer Cytopathology

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“…In one study, about 62% of HIV-positive MSM and 36% of HIVnegative MSM who had a diagnosis of LSIL at baseline progressed to HSIL within 2-4 years (Palefsky et al, 1998). A diagnosis of ASCUS may also hide squamous intraepithelial lesions (Wang et al, 2019). The presence of any abnormal anal cytological finding indicates a potential association with high-grade anal intraepithelial neoplasia (AIN) on pathological examination (Machalek et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…The most common high-risk HPV types in HIV patients worldwide are HPV 16 followed by HPV 18 (Fan et al, 2020;Nasioutziki et al, 2020). Among Spanish MSM, the most prevalent high-risk HPV was HPV 31 and in China, HPV 58 were the most frequently detected (Torres et al, 2013;Liu et al, 2019). As for low-risk HPV types, HPV 11, HPV 6 and HPV 42 were the most frequently detected.…”

Section: Discussionmentioning

confidence: 99%

Human Papillomavirus Detection and Abnormal Anal Cytology in HIV-infected Patients Using p16/Ki-67 Dual-Staining

Patarapadungkit

Khonhan

Pisuttimarn

et al. 2020

Asian Pac J Cancer Prev

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Objective: We investigated human papillomavirus (HPV) infection and detected anal squamous intraepithelial lesions by modified liquid-based cytology (LBC) and p16/Ki67 dual-staining. Methods: Anal swabs (n=393) were collected from patients with HIV infection. Anal cells were kept in 95% ethyl alcohol for modified LBC. DNA was extracted from cells for HPV detection and genotyping using real-time PCR and reverse line blot hybridization. Results: Nine samples (2.3%) were unsatisfactory specimens, 74.8% (294/393) were negative for intraepithelial malignancies (NILM) and 22.9% (90/393) exhibited squamous intraepithelial lesions (SIL). In the latter category, 13.7% of samples (54/393) contained atypical squamous cells of undetermined significance (ASCUS), 6.9% (27/393) were classified as low-grade SIL (LSIL) and 2.3% (9/393) as high-grade SIL (HSIL). A total of 331 from 393 swab samples were suitable for detection of HPV infection. Among these, 34.1% (113/331) were positive. HPV 58 (15.9%) was the most common genotype, followed by HPV 18 (14.2%) and HPV 16 (11.5%). The severity of abnormal cells was significantly associated with HPV infection. Dual staining with p16/Ki-67 was performed on 130 samples: in 30.8% (40/130) of samples positive staining was significantly associated with severity of abnormal cells. Agreement between cytology, p16/Ki67 dual-staining and high-risk HPV detection was 100% in HSIL samples. Interestingly, eight apparently NIML cases might have contained abnormal cells, since they were positive by both p16/Ki67 dual-staining and high-risk HPV detection. Conclusion: Anal specimens screened using modified LBC with 95% ethyl alcohol solution as the fixative are suitable for screening anal precancerous lesions by cytology, HPV testing and p16/Ki-67 dual staining.

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“…The lowest regression rate from LSIL to ASCUS was also reported for Hispanics [17]. In the Latin American population, a 1% progression rate for HSIL has been reported [12], with a higher risk of CIN 3 in those over 60 years of age (42.8%) [20]. As HSIL has a high proportion of CIN 2 and CIN 3, it is necessary to perform combined tests (including HPV genotyping and co-testing) to increase the possibility of detection in all age groups [21].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Three Models of Follow-up of Patients with Cervical Cytological Abnormalities in a Peruvian’s Largest Teaching Women’s Hospital

et al. 2022

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The follow-up of squamous intraepithelial lesions (SIL) allows us to understand their progression and regression, however squamous cell atypia (ASC) can generate confusing follow-up results. We aimed to describe the evolution of ASC and SIL during cyto-histopathological follow-up in a tertiary-care hospital.Materials and methods: we conducted a retrospective study during 2016 in 156 Papanicolaou test (PAP) results under three models: 1) with ≥1 PAP and biopsies, 2) 1 PAP followed by ≥1 biopsy, and 3) ≥1 PAP and a confirmatory biopsy. Progression was defined as ASCUS to low-grade SIL (LSIL) or higher, and LSIL to high-grade SIL (HSIL) or higher; and regression as HSIL to LSIL or lower; and LSIL to ASCUS or lower. Results:In PAP, 57 (36.5%) cases were ASC and in histopathology 56 (39.9%) cases of grade 1 cervical intraepithelial neoplasia. Twenty-nine (18.6%) results were followed: 8 (27.6%), 17 (58.6%), and 4 (13.8%) with models 1, 2, and 3, respectively. The progression of the lesions was reported in ~50% for models 2 and 3. ASCUS was the main cytological finding that indicated biopsies, and for all models, the mean progression and regression time was 4 and 3.1 months, respectively. Conclusions:The follow-up of cytological alterations in three models showed progression of lesions in half of the cases analyzed with a time of four months of evolution; ASCUS was the main finding that indicated histopathological study.

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Retrospective analysis of cervical cancer and precancerous lesions in patients with atypical squamous cells of undetermined significance in China

Cited by 4 publications

References 22 publications

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

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

Human Papillomavirus Detection and Abnormal Anal Cytology in HIV-infected Patients Using p16/Ki-67 Dual-Staining

Evaluation of Three Models of Follow-up of Patients with Cervical Cytological Abnormalities in a Peruvian’s Largest Teaching Women’s Hospital

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