scholarly journals Gynaecological cytology in women under the age of 30—the impact of P16/KI67 dual-staining cytology

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
F Silva ◽  
C Rocha ◽  
P Teixeira ◽  
R Oliveira ◽  
D Martins ◽  
...  
Keyword(s):  
High Rate ◽  
Medical Visit ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Ki 67 ◽  
Squamous Cells ◽  
Hpv Test ◽  
Intraepithelial Lesion ◽  
The Impact ◽  
Dual Staining

Abstract Background The HPV detection test is not recommended as a primary screening of cervical lesions, before the age of 30, because the high rate of HPV infections with a high rate of spontaneous resolution in this age group. This study aims to evaluate the performance of p16/Ki67 dual staining in detecting high-grade squamous cervical lesions in these women. Methods Cervical-vaginal samples from 67 women HPV positives under the age of 30 and cervical biopsies of 41 of these women. Results of p16/Ki67 dual staining, cytology and histology were analysed. In 53 of the women, 159 results of p16/Ki67 dual staining, HPV test and cytology, obtained in 3 follow-up medical visit, were compared. Results The p16/ki67 dual staining was positive in 23.9% and negative in 76.1% of all 67 women. All women with high squamous intraepithelial lesion cytology, 39.1% with low squamous intraepithelial lesion cytology, 17.4% with negative for intraepithelial lesion cytology and 10% with atypical squamous cells cytology, were p16/Ki-67 dual staining positives. In the 41 women with histological diagnosis, p16/ki67 dual staining showed a sensitivity of 87.5% and a specificity of 96% to detect HSIL. When comparing, the tests differ significantly (P < 0.001), p16/ki67 dual staining was positive in 24% of positive cytology and in 19.5% of positive HPV tests. Conclusions Our results demonstrate that p16/Ki67 dual stain has good sensitivity and specificity to detect HSIL and can be useful on women under the age of 30, avoiding excessive diagnosis and reducing colposcopy referrals. Further studies are required in a large number of women.

scholarly journals Assessment of the natural course and treatment of premalignant uterine cervical lesions in pregnancy

2013 ◽  
Vol 141 (3-4) ◽  
pp. 192-197 ◽  
Author(s):  
Dragisa Sljivancanin ◽  
Vesna Kesic ◽  
Lidija Tulic ◽  
Jelena Dotlic
Keyword(s):  
Preterm Births ◽  
Spontaneous Remission ◽  
Natural Course ◽  
High Rate ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Cervical Lesions ◽  
Similar Frequency ◽  
Intraepithelial Lesion ◽  
The Impact

Introduction. Premalignant changes of the uterine cervix occur with similar frequency during pregnancy and in non?pregnant women. Due to the fact that any surgery on the cervix can jeopardize pregnancy, it is important to define the protocol of procedures for the treatment of these changes during pregnancy. Objective. The aim of the study was to investigate the natural course of premalignant cervical changes during pregnancy and the impact of their treatment on the pregnancy course. Methods. Study involved all patients with colposcopically, cytologically and hystopathologically diagnosed premalignant cervical changes during pregnancy from 2002 to 2008. Patients were divided into two groups according to the applied treatment during pregnancy: surgery or monitoring by regular colposcopic and cytological examinations. The two groups were compared concerning treatment outcome, persistence or regression of changes and pregnancy duration. Results. Study involved 58 patients. Spontaneous remission of lesions occurred after pregnancy in 63.79% of cases. Highgrade squamous intraepithelial lesion (H?SIL) demonstrated a higher rate of persistency in comparison with low?grade squamous intraepithelial lesion (L?SIL) (?2=25.115; p<0.05). Only one finding of L?SIL progressed into H?SIL in the monitored group. Patients who underwent conization during pregnancy had a significantly more frequent preterm deliveries (?2=14.369; p<0.05). Conclusion. The obtained high rate of spontaneous regression of cervical changes after pregnancy as well as the lower incidence of preterm births in patients who were not treated by conization during pregnancy, confirm that patients with premalignant cervical changes should be, if invasion is excluded, under follow?up throughout pregnancy by regular colposcopic and cytological examinations. Therapeutic conization, due to numerous complications, should be performed only when there is a suspected presence of a more severe form of the disease (micro invasive and invasive carcinoma).

Human Papillomavirus Testing and Reporting Rates: Practices of Participants in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology in 2006

2008 ◽  
Vol 132 (8) ◽  
pp. 1290-1294 ◽  
Author(s):  
Ann T. Moriarty ◽  
Mary R. Schwartz ◽  
Galen Eversole ◽  
Marilee Means ◽  
Amy Clayton ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Interlaboratory Comparison ◽  
Low Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Frequency Distributions ◽  
Squamous Cells ◽  
Hpv Test ◽  
Intraepithelial Lesion

Abstract Context.—Oncogenic, high-risk human papillomavirus (HR-HPV) testing is used to evaluate women who are older than 20 years with atypical squamous cells of undetermined significance (ASC-US) and in conjunction with a screening Papanicolaou test in women older than 30 years. Objectives.—To evaluate the 2006 laboratory practice data from laboratories incorporating human papillomavirus (HPV) testing with the Papanicolaou test. Design.—To use the College of American Pathologists (CAP) Supplemental Questionnaire Survey for 2006 to determine laboratory practices of participants in the CAP Interlaboratory Comparison Program in Cervicovaginal Cytology. Results.—A total of 679 laboratories responded to the questionnaire. Most (73%) refer HPV testing to reference laboratories. Nine percent perform HPV testing in cytology. Forty-five percent offer low-risk HPV (LR-HPV) testing. The most common reflex is ASC-US, although HR-HPV is also offered with low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), or any other Papanicolaou test result. Digene Hybrid Capture II is the most common method. Human papilloma virus median test volumes are 55 monthly. Frequency distributions of HPV test volumes are significantly different from those found in 2003. Laboratories performing in-house testing reported significantly higher monthly HPV volumes (P &lt; .001). Median rates for HR-HPV positivity are 36.6% for ASC-US, 50.0% for atypical squamous cells, cannot exclude HSIL (ASC-H), and 4% for women 30 years of age and older in conjunction with a screening Papanicolaou test. Conclusions.—Reference HPV testing remains the most common pattern. The most common reflex indication is for ASC-US, but HPV testing is modified locally to include a variety of scenarios. LR-HPV testing is commonly offered despite its lack of clinical significance. These data form a baseline for ongoing monitoring of HPV testing practice trends.

scholarly journals Management of Atypical Squamous Cell Cases: A Prospective Study of Women seen at a Private Health Service in Northeastern Brazil

2018 ◽  
Vol 40 (03) ◽  
pp. 121-126 ◽  
Author(s):  
Geilson Oliveira ◽  
Judite Oliveira ◽  
Renata Eleutério ◽  
José Eleutério Júnior
Keyword(s):  
Northeastern Brazil ◽  
National Guideline ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
National Guidelines ◽  
Squamous Cells ◽  
Negative Results ◽  
Hpv Test ◽  
Intraepithelial Lesion

Objective To assess the management chosen by gynecologists after atypical squamous cells (ASCs) cytology results, and to evaluate the outcomes of these cases in Brazilian women. Methods A prospective observational study evaluated the initial management offered by the gynecologist in the case of 2,458 ASCs cytology results collected between January of 2010 and July of 2016. The outcomes of the cytology, high-risk human papilloma virus (HR-HPV) test and histology were compared in two subgroups: atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H). Results In many cases of ASC-US (36.97%) and ASC-H (40.50%), no clinical actions were taken. Cytology was the most frequent follow-up chosen, including for cases of ASC-H, which goes against the conduct recommended in the national guideline. In women over 30 years of age, the period of time elapsed between an ASC-US result and a new cytology was in 13.03 months, in disagreement with the national guideline recommendations (p < 0.0001). Negative for intraepithelial lesions or malignancy (NILM) cytologic (p = 0.0026) and histologic (p = 0.0017) results in the follow-up were associated with prior ASC-US, while negative results for ASC-H were cytologically (p < 0.0001) and histologically associated with high-grade squamous intraepithelial lesion (HSIL) (p < 0.0001). Two invasive cervical carcinomas (ICCs) were found in the follow-up for ASC-H, and there was a statistically significant association (p = 0.0341). A positive HR-HPV test was associated with ASC-H (p = 0.0075). Conclusion The data suggest that even for a population of Brazilian women assisted at private clinics, the national guidelines recommendations for ASCs results are not followed.

scholarly journals p16/Ki-67 dual staining has a better accuracy than human papillomavirus (HPV) testing in women under 30 years old

2018 ◽  
Author(s):  
Laurențiu Pirtea ◽  
Cristina Secosan ◽  
Madalin Margan ◽  
Lavinia Moleriu ◽  
Oana Balint ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Sensitivity And Specificity ◽  
Pap Smear ◽  
High Rate ◽  
Low Grade ◽  
High Grade ◽  
Cervical Lesions ◽  
Ki 67 ◽  
Hpv Genotyping ◽  
Dual Staining

Due to a high rate of transient human papillomavirus (HPV) infection, HPV genotyping has a low specificity for high-grade cervical lesions, especially in young women. p16/Ki-67 dual immunohistochemical staining can also be used for the detection of oncogenic changes in cervical cells. Our aim was to compare the performance of p16/Ki-67 dual staining and HPV genotyping in the detection of high-grade cervical lesions in patients with atypical squamous cells of undetermined significance (ASCUS)/low-grade squamous intraepithelial lesion (LSIL) on Pap smear. We retrospectively analyzed 310 patients with ASCUS/LSIL on Pap smear, who underwent colposcopy. Among these, 161 patients with suspected lesions detected by colposcopy were referred to biopsy. HPV genotyping by LINEAR ARRAY HPV Genotyping Test (CE-IVD) and p16/Ki-67 dual staining by CINtec PLUS Cytology kit was performed prior to cervical biopsy. The overall sensitivity and specificity of HPV genotyping for the detection of cervical intraepithelial neoplasia (CIN) 2-3 was 79% and 72%, respectively in patients with ASCUS, and 85% and 64%, respectively in patients with LSIL. For p16/ki-67 test, sensitivity and specificity rate was 66% and 93%, respectively in ASCUS and 59% and 79%, respectively in LSIL group. The specificity of p16/Ki-67 staining was significantly higher in both groups in patients aged <30 years compared to patients >30 years old (p < 0.001). Our results showed that p16/Ki-67 dual staining has a higher specificity compared to HPV genotyping, especially in patients under 30 years old. This indicates the usefulness of p16/Ki-67 testing in the triage of patients with ASCUS/LSIL and <30 years old, prior to the referral to colposcopy and biopsy.

scholarly journals Atypical Squamous Cells of Undetermined Significance: Bethesda Classification and Association with Human Papillomavirus

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Ana Cristina Macêdo Barcelos ◽  
Márcia Antoniazi Michelin ◽  
Sheila Jorge Adad ◽  
Eddie Fernando Candido Murta
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Trichomonas Vaginalis ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Squamous Cells ◽  
Hpv Test ◽  
Intraepithelial Lesion ◽  
High Risk Hpv ◽  
Undetermined Significance

Introduction. To analyze patients with atypical squamous cells of undetermined significance (ASCUS) through a cytology review and the presence of microbiological agents, with consideration of colposcopy and semiannual tracking.Methods. 103 women with ASCUS were reviewed and reclassified: normal/inflammatory, ASCUS, low-grade squamous intraepithelial lesion (LSIL), or high-grade squamous intraepithelial lesion (HSIL). If ASCUS confirmed, it was subclassified in reactive or neoplastic ASCUS, ASC-US, or ASC-H; and Regione Emilia Romagna Screening Protocol. Patients underwent a colposcopic examination, and test forCandidasp., bacterial vaginosis,Trichomonas vaginalis, and human papillomavirus (HPV) were performed.Results. Upon review, ASCUS was diagnosis in 70/103 (67.9%), being 38 (54.2%) reactive ASCUS and 32 (45.71%) neoplastic ASCUS; 62 (88.5%) ASC-US and 8 (11.41%) ASC-H. ASCUS (Regione Protocol), respectively 1-5: 15 (21.4%), 19 (27.1%), 3 (27.1%), 16 (22.8%), and 1 (1.4%). A higher number of cases of cervical intraepithelial neoplasia (CIN) II/III in the biopsies of patients with ASC-H compared to ASC-US (P=.0021). High-risk HPV test and presence of CIN II/III are more frequent in ASC-H than ASC-US (P=.031).Conclusions. ASC-H is associated with clinically significant disease. High-risk HPV-positive status in the triage for colposcopy of patients with ASC-US is associated with increased of CIN.

Effects of Implementing the Dual Papanicolaou Test Interpretation of ASC-H and LSIL Following Bethesda 2014

2020 ◽  
Vol 154 (4) ◽  
pp. 553-558
Author(s):  
Abha Goyal ◽  
Ami P Patel ◽  
Thomas L Dilcher ◽  
Susan A Alperstein
Keyword(s):  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Hpv Test ◽  
Intraepithelial Lesion ◽  
The Impact

Abstract Objectives To evaluate the impact of implementing the dual interpretation of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) and low-grade squamous intraepithelial lesion (LSIL) after the Bethesda System 2014 and to compare it with other indeterminate interpretations. Methods Rates of high-risk human papillomavirus (HPV) positivity and histologic follow-up and the proportion of women with high-grade squamous intraepithelial lesion on histologic follow-up were compared for the combined interpretation of ASC-H and LSIL (ASCHL) and the categories of LSIL, cannot exclude high-grade squamous intraepithelial lesion (LSIL-H) and ASC-H. Results The percentage of ASCHL HPV-positive cases (86.0%) was similar to that of LSIL-H but significantly higher in comparison to that of ASC-H. The rates of cervical intraepithelial neoplasia grade 2 or higher (CIN 2+) and CIN 3+ for ASCHL (29.6% and 3.6%, respectively) were similar to those of LSIL-H and ASC-H. When stratified by HPV test results, the proportions of patients with CIN 2+ and CIN 3+ remained statistically similar to those with ASCHL and with LSIL-H and ASC-H. Conclusions Considering the similar risks of CIN 2+ and CIN 3+ for ASCHL and ASC-H, having a separate category of ASCHL for reporting cervical cytology appears to be redundant.

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