Can We Reduce Overtreatment of Cervical High-Grade Squamous Intraepithelial Lesions?

2022 ◽  
Vol 26 (1) ◽  
pp. 20-26
Author(s):  
Melissa Bradbury ◽  
Jordi Rabasa ◽  
Maria Teresa Murcia ◽  
Maria Carme Dinarès ◽  
Alex Sainz ◽  
...  
Keyword(s):  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Intraepithelial Lesions

Prognostic markers of high-grade squamous intraepithelial lesions: the role of p16INK4aand high-risk human papillomavirus

2007 ◽  
Vol 86 (1) ◽  
pp. 94-98 ◽  
Author(s):  
José Eleutério Jr ◽  
Paulo César Giraldo ◽  
Ana Katherine Gonçalves ◽  
Diane Isabelle Magno Cavalcante ◽  
Francisco Valdeci de Almeida Ferreira ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Prognostic Markers ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Intraepithelial Lesions

Relevance of the Pap Test: A Report of HPV-DNA Test-Negative High-Grade Squamous Intraepithelial Lesions of the Female Lower Genital Tract

2016 ◽  
Vol 60 (5) ◽  
pp. 445-450 ◽  
Author(s):  
Yiang Hui ◽  
Katrine Hansen ◽  
Jayasimha Murthy ◽  
Danielle Chau ◽  
C. James Sung ◽  
...  
Keyword(s):  
High Risk ◽  
Pap Test ◽  
Human Papillomaviruses ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Cytologic Examination ◽  
Dna Test ◽  
Hpv Dna ◽  
Intraepithelial Lesions ◽  
Hpv Dna Test

Objective: A vast majority of cervicovaginal intraepithelial lesions are caused by high-risk human papillomaviruses (HPVs). The Pap test has been the sole method used for the screening of cervicovaginal squamous intraepithelial lesions (SIL). Recently, the FDA approved an HPV-DNA assay as a method of primary screening. We report on a series of FDA-approved HPV-DNA test-negative SIL with HPV genotyping, using an alternative method on the corresponding surgical biopsy specimens. Study Design: A retrospective review identified cytology-positive HPV-negative cases over a 15-month period at a tertiary care gynecologic oncology institution. Corresponding biopsies were reviewed and genotyped for high-risk HPVs. Results: Of the 18,200 total cases, 17 patients meeting the study criteria were selected with 27 surgical specimens corresponding to their cytologic diagnoses. Four patients with high-grade lesions were identified, 3 of whom (75%) were positive for HPV. One of these 4 patients (25%) showed high-grade SIL on biopsies from 4 separate sites in the cervix and vagina. Multiviral HPV infections were frequent. Conclusions: We discuss the relevance of cotesting for screening cervical SILs and emphasize that false-negative results are possible with the FDA-approved HPV screening assay, also in patients with high-grade SIL. These cases may be detectable by cytologic examination and this suggests that the Pap test remains an important diagnostic tool.

Interobserver Variability in Subclassification of Squamous Intraepithelial Lesions

1999 ◽  
Vol 123 (11) ◽  
pp. 1079-1084 ◽  
Author(s):  
Sherry L. Woodhouse ◽  
Janet F. Stastny ◽  
Patricia E. Styer ◽  
Mary Kennedy ◽  
Amy H. Praestgaard ◽  
...  
Keyword(s):  
Interlaboratory Comparison ◽  
Interobserver Variability ◽  
High Grade ◽  
Test Results ◽  
Squamous Intraepithelial Lesions ◽  
Papanicolaou Test ◽  
Management Guidelines ◽  
Significant Difference ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Abstract Objective.—To determine whether, on a national cytology proficiency test, a competent cytologist can consistently distinguish grades of squamous intraepithelial lesions. Design.—Results for low- and high-grade squamous intraepithelial lesion referenced slides from the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology for 1996 and 1997 were analyzed including educational, nongraded vs graded validated slides. Results.—The discrepant rate between low- and high- grade lesions ranged from 9.8% to 15% for cytotechnologist, pathologist, laboratory, and all responses. There was a statistically significant difference in performance on graded, validated slides vs educational slides with better performance on validated slides. Conclusion.—This significant interobserver variability in subclassification of squamous lesions should be considered in management guidelines for abnormal Papanicolaou test results and implementation of national cytology proficiency testing.

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