What is the Retrospective Correlation between High- Grade Squamous Intraepithelial Lesion (HSIL) on Cytology and the Histological Diagnosis of Cervical Intraepithelial Neoplasia 2 (CIN2) or More in AML, Antwerp, Belgium?

Abstract

Introduction: Cervical cancer is a major worldwide health problem. Therefore, regular cervical screening in order to make an early diagnosis can help to prevent cervical cancer. The aim of this retrospective study is to evaluate the correlation between HSIL on cytology and histological CIN2+ in AML, Antwerp and to compare two liquid-based cytological techniques ThinPrep® LBC (TP) and SurePath™ LBC (SP).Methods: 120 women with a HSIL positive cytological smear from 2014 (ThinPrep® LBC) and another 120 from 2010 (SurePath™ LBC) were anonymously randomised out of the AML database, according to predefined in-and exclusion criteria. The Belgian Cancer Registry (CIB and CHP) and the AML database were consulted for histological and cytological data and the researched variables (doctor's speciality, age, HPV status, -genotypes and -persistence) of these 240 women. 184 women, with histological follow-up within one year, out of 240 were included. Statistical analysis was performed using Stata 15.1 (StataCorp, USA). P-values and Odds-ratios were calculated. Results:The CIN2+/HSIL ratio of all included 184 subjects was 75.5% (95%CI=69.3-81.8). The found CIN2+ percentages for TP and SP, were 75.8% (95%CI 67.0-84.6) and 75.3% (95%CI 66.5-84.1) respectively. For all included subjects the variables hrHPV infection (p=0,008; OR=6.97) and HPV16 infection (p=0.004; OR=2.79) were statistically significant for having CIN2+ on histology. Conclusions:The found CIN2+/HSIL ratio of 75.5% in AML, Antwerp is similar to the percentages found in worldwide laboratories. HSIL positive women who are HPV16+ or hrHPV+ are at significant higher risk for invasive cervical disease. No statistically significant difference in CIN2+% was found between the two LBC techniques TP and SP.