Significance of High-Risk Human Papillomavirus Testing for Atypical Glandular Cells on Cervical Cytology

Abstract

Objectives: The aim of this study was to evaluate the diagnostic significance of high-risk human papillomavirus (hrHPV) testing for managing women with atypical glandular cells (AGC) and to explore the distribution of hrHPV genotypes. Methods: We analyzed cytologic and histopathologic diagnoses in patients referred to our institution due to AGC or atypical squamous cells of undetermined significance (ASC-US). All patients underwent hrHPV testing and genotyping, and positive (PPV) and negative predictive values (NPV) for cervical intraepithelial neoplasia (CIN) 2 or worse [CIN2+/adenocarcinoma in situ (AIS)+] were calculated. Results: Among 41 cases previously diagnosed with AGC, 22 (53%) were classified as CIN2+ (2 squamous cell carcinomas), whereas only 2 were AIS or adenocarcinoma. Twenty-seven (65.8%) cases in the AGC group were hrHPV positive. The most frequent genotypes in both the ASC-US and AGC groups were HPV16 and HPV52. The PPV of hrHPV testing for CIN2+/AIS+ was significantly higher in the AGC than in the ASC-US group (74.1 vs. 35.0%; p = 0.0005). The NPV for CIN2+/AIS+ was significantly lower in the AGC than in the ASC-US group (74.4 vs. 100%; p = 0.0441). Conclusion: In patients with AGC, both glandular and squamous lesions must be monitored. hrHPV testing is useful for detecting CIN2+/AIS+ in AGC.

Assessment of Human Papillomavirus Non-16/18, Type-Specific Risk for Cervical Intraepithelial Neoplasia Grade 3 or Worse Among Women With Cervical Atypical Glandular Cells

“…The sizeable CIN 3 or worse risk we found for all different groups of HPV types support this recommendation. Nevertheless, as other studies have also shown, the risk for cervical precancer and invasive cancer associated with HPV positivity 4–6 and different HPV types 7,21–24 might be useful for the management of AGC. Risk stratification by HPV types might also be helpful to assist prioritization of women for follow-up when resources and referral capacity are limited.…”

“…A study from Korea found that HPV genotypes 51/52/53/56/58/59 combined were the most frequent types after HPV16/18 among 90 high-risk HPV-positive AGC cases. 22 From their study in Japan, Komatsu et al 23 Namugenyi et al 24 found HPV45 and 68 to be most common high-risk HPV types after HPV16 among 18 high-risk-positive women with AGC. A multiinstitutional retrospective study by Bogani and colleagues 25 from Italy found HPV58 and HPV31 to be the most common types after HPV16/18 among 136 AGC cases with positive HPV DNA testing.…”

“…A study from Korea found that HPV genotypes 51/52/53/56/58/59 combined were the most frequent types after HPV16/18 among 90 high-risk HPV-positive AGC cases. 22 From their study in Japan, Komatsu et al 23 found HPV52 to be the most common type together with HPV16 among 27 high-risk HPV–positive women with AGC. A case–control study from the United States conducted by Namugenyi et al 24 found HPV45 and 68 to be most common high-risk HPV types after HPV16 among 18 high-risk–positive women with AGC.…”

An audit of liquid‐based cytology samples reported as high‐risk human papillomavirus and borderline nuclear change in endocervical cells

“…Recommendations for practice based on our findings and the current literature would be to consider HR HPV plus BNC in endocervical cells a high‐grade referral (ie, to be assessed in colposcopy within 2 weeks of the referral) and efforts should be made not to rebook these women. Due to the low incidence of this cytological finding, this should not have a significant impact upon the workload of a colposcopy department.…”