scholarly journals HPV Testing and Pap Test: Role for a Combined Approach in a Non-Screened Population

2006 ◽  
Vol 21 (3) ◽  
pp. 149-156 ◽  
Author(s):  
I. Marchetti ◽  
K. Zavaglia ◽  
G. Bertacca ◽  
P. Aretini ◽  
B. Matteoli ◽  
...  
Keyword(s):  
Pap Test ◽  
Hpv Infection ◽  
Low Grade ◽  
Cytological Diagnosis ◽  
Squamous Intraepithelial Lesions ◽  
Cervical Lesions ◽  
Dot Blot ◽  
Screening Programs ◽  
Hpv Test ◽  
Intraepithelial Lesions

The aim of the present study was to test the polymerase chain reaction (PCR) as a tool to identify human papillomavirus (HPV) in routine cytological samples scraped from the uterine cervix. Moreover, attention has been focused on the correlation between HPV types and early intraepithelial lesions. The study involved 586 women who had undergone conventional Pap test. Analysis of HPV infection was performed by PCR and HPV typing by dot blot. In a group of 78 cases histologically diagnosed as high-grade squamous intraepithelial lesions (HSILs), the cytological diagnosis was correct in 92.3% and the HPV test was positive in 89.8% of cases; combined positivity at Pap and/or HPV tests raised this figure to 99.0%. In a group of 67 cases histologically diagnosed as low-grade squamous intraepithelial lesions (LSILs), the cytological diagnosis was correct in 73.1% and the PCR-based HPV test was positive in 64.2%; combined positivity at Pap and/or HPV tests raised this figure to 91.0%. This study confirms the limitations of screening programs based on Pap test only. Our results suggest, in fact, that adding the HPV test to primary screening could increase the yield of preinvasive cervical lesions.

scholarly journals Do Infection Patterns of Human Papillomavirus Affect the Cytologic Detection of High-Grade Cervical Lesions on Papanicolaou Tests?

2017 ◽  
Vol 142 (3) ◽  
pp. 347-352 ◽  
Author(s):  
Siavash Azadmanesh Samimi ◽  
Roxanne R. Mody ◽  
Steven Goodman ◽  
Eric Luna ◽  
Donna Armylagos ◽  
...  
Keyword(s):  
Hpv Infection ◽  
Low Grade ◽  
Lower Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Cervical Lesions ◽  
Atypical Squamous Cell ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions ◽  
Hpv 18

Context.— Persistent infection with high-risk human papillomavirus (hrHPV) is the major cause of cervical cancer. The effect of HPV infection patterns on cytologic detection of cervical lesions is unknown. Objective.— To determine the effect of HPV infection patterns on the sensitivity of cytologic detection of high-grade cervical lesions. Design.— Papanicolaou tests from 257 women with biopsy-confirmed, high-grade squamous intraepithelial lesions were analyzed with respect to HPV infection patterns. Results.— Among 257 biopsy-confirmed, high-grade squamous intraepithelial lesion cases, the preceding cytology showed 20 cases (8%) were benign; 166 cases (65%) were low-grade cervical lesions, including atypical squamous cell of undetermined significance and low-grade squamous intraepithelial lesions; and 71 cases (28%) were high-grade cervical lesions, including atypical squamous cells cannot rule out high-grade squamous intraepithelial lesion (atypical squamous cell–high), atypical glandular cells, and high-grade squamous intraepithelial lesions. In 236 cases tested for HPV, those exhibiting low-grade cervical lesions on cytology were often associated with coinfections of mixed hrHPV genotypes (31 of 40; 78%) or non-16/18 hrHPV (75/103; 73%), compared with single-genotype infections of HPV-16 (33 of 62; 53%) or HPV-18 (2 of 6; 33%) (P = .001). In contrast, high-grade cervical lesion cytomorphology tended to associate with the single-genotype infection of HPV-16 (20 of 62; 32%) or HPV-18 (3 of 6; 50%), compared with non-16/18 hrHPV (25 of 103; 24%) or multigenotype infection (8 of 40; 20%) (P = .01). Conclusions.— Our findings suggest that multigenotypic or non-16/18 hrHPV infections often produce deceptive lower-grade cytomorphology, which could result in underdiagnosis and delay of treatment. The HPV infection patterns may offer unrecognized benefit beyond HPV genotyping and should be considered during clinical risk evaluation of women with lower-grade cytology.

scholarly journals Colposcopy, cervical cytology and human papillomavirus detection as screening tools for cervical cancer

2001 ◽  
Vol 7 (1-2) ◽  
pp. 100-105
Author(s):  
Al Alwan Al Alwan
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Pap Test ◽  
Screening Tools ◽  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Sampling Device ◽  
Squamous Cells ◽  
The Bethesda System ◽  
Intraepithelial Lesions

A cohort of 77 women referred for routine screening or investigation of Pap test abnormality underwent colposcopic examination. Pap-stained liquid-based preparations were diagnosed and categorized according to the Bethesda system. Residual material on the sampling device was used to detect high-risk oncogenic human papillomavirus DNA. Although the colposcopic failure rate was higher than that of cytology, no lesion was missed when both methods were used together. High-risk types were recorded in 24% of patients with atypical squamous cells of undetermined significance, 45% with low-grade squamous intraepithelial lesions and 79% with high-grade squamous intraepithelial lesions-indicating that the efficacy of cytological screening can be improved by papillomavirus detection.

scholarly journals Risk factors modulating the course of low-grade squamous intraepithelial lesions in women of reproductive age

2021 ◽  
Vol 17 (1) ◽  
pp. 45-52
Author(s):  
T.  S. Prisyazhnaya ◽  
V.   A. Mikhaylyukova ◽  
I.   V. Berlev ◽  
A.   V. Malek
Keyword(s):  
Risk Factors ◽  
Sexual Behavior ◽  
Risky Sexual Behavior ◽  
Hpv Infection ◽  
Reproductive Age ◽  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Women Of Reproductive Age ◽  
Cytological Abnormalities ◽  
Intraepithelial Lesions

Background. Infection with oncogenic types of human papillomavirus (HPV) is the leading cause of cervical cancer and its immediate precursors – squamous intraepithelial lesions. However, the persistence of HPV may not be sufficient for the occurrence of malignant transformation, and there may be other exogenous or endogenous factors that, in combination with the virus, increase the risk of developing and progressing cervical neoplasia.Objective: identification of risk factors that modulate the course of low-grade squamous intraepithelial lesions (LSIL) in women of reproductive age.Materials and methods. In 110 women aged 18 to 45 years with a diagnosis of LSIL, we evaluated the impact of risk factors (sexual behavior, reproductive function, contraceptive methods, smoking, HPV infection) on the course of the process (recovery, persistence or progression) during the 12-month follow-up period. HPV testing was performed by real-time PCR.Results. The average age of the study participants was 31.55 ± 7.17 years. Our observations showed that frequent artificial abortions, the practice of risky sexual behavior (early sexual debut, frequent change of sexual partners) increased the risk of persistence and progression of mild cervical cytological abnormalities. The use of oral contraceptives, barrier contraception and smoking did not affect the outcome of the disease.The prevalence of HPV among women with LSIL was 70.91 % (78/110). The predominant types were HPV 16 (35.45 %), HPV 33 (12.73 %) and HPV 18 (12.73 %). HPV 16 was more common in the progression group (62.50 %) than in the regression and persistence groups (14.63 % and 43.40 %, p <0.05). Progression of neoplasias was more often observed in patients with signs of multiinfection of the cervical epithelium with HPV. Single HPV infection was higher in the group of recovered women.Conclusions. The study found that a large number of induced abortions, the practice of risky sexual behavior, the presence of HPV type 16 and multiple HPV infection are factors contributing to the persistence of LSIL and progression to HSIL. These data may be useful for the management of women with mild cervical cytological abnormalities.

scholarly journals Coinfection of High-Risk Human Papillomavirus and Lower Genital Tract Pathogens in the Development of High-Grade Cervical Lesions

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Hui Zhong ◽  
Yao Tong ◽  
Haifeng Lin ◽  
Xiaodan Mao ◽  
Binhua Dong ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Genital Tract ◽  
Hpv Infection ◽  
High Grade ◽  
Infection Rates ◽  
Squamous Intraepithelial Lesions ◽  
Cervical Lesions ◽  
Lower Genital Tract ◽  
Intraepithelial Lesions

Purpose. This study investigated the infection status and relationship between other common lower genital tract infectious pathogens and high-risk human papillomavirus (HR-HPV) in the high-grade cervical lesions. Methods. Overall, 882 patients were enrolled in this retrospective study, of which 339 patients (≥HSIL group) were confirmed with high-grade squamous intraepithelial lesions (HSIL) or cervical squamous cell carcinoma (SCC), while 543 patients (≤LSIL group) were diagnosed with low-grade squamous intraepithelial lesions (LSIL) or normal cervical pathology diagnosis. Cervical swab specimens were tested for HPV, pathogenic bacteria (PB), U. urealyticum (UU), M. hominis (MH), and C. trachomatis (CT) in both groups. Results. The infection rates of HR-HPV, PB, UU (at high density), and CT were higher in the ≥HSIL group than in the ≤LSIL group (P<0.001); however, higher infection rates with MH were not observed (P>0.05). PB, UU, and CT were associated with HR-HPV infection (P<0.001). The PB and UU infection rates in the ≥HSIL group were significantly different from those in the ≤LSIL group, regardless of whether there was an HR-HPV infection at the same time (P<0.05). However, this was not the case for the CT (P>0.05). Furthermore, 259 pathogenic bacterial strains were detected in 882 cases. The difference in the distribution of pathogenic bacterial flora in the different grades of cervical lesions had no statistical significance, which was prioritized over Escherichia coli (P>0.05). Conclusion. PB, UU, and CT infection is associated with susceptibility to HR-HPV, HR-HPV coinfection with these pathogens might increase the risk of high-grade cervical lesions, and PB and UU might be independent risk factors for cervical lesions.

Accuracy of telomerase in cervical lesions: a systematic review

2007 ◽  
Vol 17 (6) ◽  
pp. 1205-1214 ◽  
Author(s):  
M. I. Rosa ◽  
L. R. Medeiros ◽  
M. C. Bozzetti ◽  
J. Fachel ◽  
E. Wendland ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intraepithelial Neoplasia ◽  
Cervix Cancer ◽  
Early Event ◽  
Low Grade ◽  
Cervical Carcinogenesis ◽  
Benign Lesions ◽  
Squamous Intraepithelial Lesions ◽  
Cervical Lesions ◽  
Intraepithelial Lesions

The detection of telomerase activity in cervix may provide information on cervical carcinogenesis and may be a marker to monitor cervical intraepithelial neoplasia transition. A quantitative systematic review was performed to estimate the accuracy of telomerase assay in cervical lesions. Studies that evaluated the telomerase test (telomerase repeated amplification protocol) for the diagnosis of cervix lesions and compared it to paraffin-embedded sections as the diagnostic standard were included. Ten studies were analyzed, which included 1069 women. The diagnostic odds ratio (DOR) for a positive telomerase test for low-grade squamous intraepithelial lesions (Lo-SIL) vs normal or benign lesions was 3.2 (95% CI, 1.9–5.6). The DOR for a positive telomerase test for high-grade squamous intraepithelial lesions (Hi-SIL) vs Lo-SIL, normal or benign lesions was 5.8 (95% CI, 3.1–10). For cervix cancer vs Hi-SIL, the DOR for a positive telomerase test was 8.1 (95% CI, 3.2–20.3) and for cervix cancer vs Lo-SIL, normal or benign lesions, it was 40.9 (95% CI, 18.2–91). Our data support the current hypothesis that telomerase may activate an early event in cervical carcinogenesis that could be associated with the initiation and progression of cervical lesions

scholarly journals Multiple HPV Infections and Viral Load Association in Persistent Cervical Lesions in Mexican Women

Viruses ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 380 ◽  
Author(s):  
Mariel A. Oyervides-Muñoz ◽  
Antonio A. Pérez-Maya ◽  
Celia N. Sánchez-Domínguez ◽  
Anais Berlanga-Garza ◽  
Mauro Antonio-Macedo ◽  
...  
Keyword(s):  
Viral Load ◽  
Dna Analysis ◽  
Invasive Cervical Cancer ◽  
Hpv Infection ◽  
Low Grade ◽  
Cervical Lesions ◽  
Screening Programs ◽  
Viral Loads ◽  
Hpv Types

Persistent high-risk human papillomavirus (HR-HPV) infections play a major role in the development of invasive cervical cancer (CC), and screening for such infections is in many countries the primary method of detecting and preventing CC. HPV typing can be used for triage and risk stratification of women with atypical squamous cells of undetermined significance (ASC-US)/low-grade cervical lesions (LSIL), though the current clinical practice in Mexico is to diagnose CC or its preceding conditions mainly via histology and HR-HPV detection. Additional information regarding these HPV infections, such as viral load and co-infecting agents, might also be useful for diagnosing, predicting, and evaluating the possible consequences of the infection and of its prevention by vaccination. The goal of this follow-up hospital case study was to determine if HPV types, multiple HPV infections, and viral loads were associated with infection persistence and the cervical lesion grade. A total of 294 cervical cytology samples drawn from patients with gynecological alterations were used in this study. HPV types were identified by real-time PCR DNA analysis. A subset of HPV-positive patients was reevaluated to identify persistent infections. We identified HPV types 16, 18, and 39 as the most prevalent. One hundred five of the patients (59%) were infected with more than one type of HPV. The types of HPV associated with multiple HPV infections were 16, 18, and 39. In the follow-up samples, 38% of patients had not cleared the initially detected HPV infection, and these were considered persistent. We found here an association between multiple HPV infections and high viral loads with and infection persistence. Our findings suggest there are benefits in ascertaining viral load and multiple HPV infections status of HR-HPV infections for predicting the risk of persistence, a requirement for developing CC. These findings contribute to our understanding of HPV epidemiology and may allow screening programs to better assess the cancer-developing risks associated with individual HR-HPV infections.

scholarly journals The CpG island methylator phenotype increases the risk of high-grade squamous intraepithelial lesions and cervical cancer

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Jaqueline Loaeza-Loaeza ◽  
Berenice Illades-Aguiar ◽  
Oscar del Moral-Hernández ◽  
Yaneth Castro-Coronel ◽  
Marco A. Leyva-Vázquez ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Dna Methylation ◽  
Cpg Island ◽  
Hpv Infection ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Cpg Island Methylator Phenotype ◽  
Methylator Phenotype ◽  
Intraepithelial Lesions

Abstract Background High-risk human papillomavirus (HR-HPV) infection is the main cause of cervical cancer, but additional alterations are necessary for its development. Abnormal DNA methylation has an important role in the origin and dissemination of cervical cancer and other human tumors. In this work, we analyzed the methylation of eight genes (AJAP1, CDH1, CDH13, MAGI2, MGMT, MYOD1, RASSF1A and SOX17) that participate in several biological processes for the maintenance of cell normality. We analyzed DNA methylation by methylation-specific PCR (MSP) and HPV infection using the INNO‑LiPA genotyping kit in 59 samples diagnostic of normal cervical tissue (non-SIL), 107 low-grade squamous intraepithelial lesions (LSILs), 29 high-grade squamous intraepithelial lesions (HSILs) and 51 cervical cancers (CCs). Results We found that all samples of LSIL, HSIL, and CC were HPV-positive, and the genotypes with higher frequencies were 16, 18, 51 and 56. In general, the genes analyzed displayed a significant tendency toward an increase in methylation levels according to increasing cervical lesion severity, except for the CDH13 gene. High CpG island methylator phenotype (CIMP) was associated with a 50.6-fold (95% CI 4.72–2267.3)-increased risk of HSIL and a 122-fold risk of CC (95% CI 10.04–5349.7). Conclusions We found that CIMP high was significantly associated with HSIL and CC risk. These results could indicate that CIMP together with HR-HPV infection and other factors participates in the development of HSIL and CC.

PROBLEM-ORIENTED COMPUTER SYSTEM - A TOOL FOR DECISION-MAKING IN THE DIAGNOSIS OF SQUAMOUS INTRAEPITHELIAL LESIONS

2020 ◽  
pp. 106-113
Author(s):  
Галина Михелевна Попова ◽  
Василий Николаевич Степанов ◽  
Надежда Васильевна Мельникова ◽  
Ирина Борисовна Антонова ◽  
Владимир Константинович Боженко
Keyword(s):  
Decision Making ◽  
Classification Accuracy ◽  
Pap Test ◽  
Neural Network Classifier ◽  
Squamous Intraepithelial Lesions ◽  
Screening Programs ◽  
System A ◽  
Decision Making System ◽  
Reflex Testing ◽  
Intraepithelial Lesions

Внедрение технологий искусственного интеллекта в практическую медицину - тенденция настоящего времени. Для объективизации процесса дифференцированной диагностики плоскоклеточных интраэпителиальных поражений (SIL) рассматривается возможность использования автоматизированного нейросетевого классификатора с денормализованными данными - результатами экспрессии мРНК 24 генной панели в материале консервирующего раствора Пап-теста CellPrep (детектирующий амплификатор «ДТ Прайм»). Проанализирована точность классификации двух клинически важных групп: HSIL+ и LSIL/доброкачественные изменения, что позволит включать данную систему принятия решений в алгоритм обследования пациенток с плоскоклеточными интраэпителиальными поражениями и рассматривать данную систему принятия решений как возможный этап рефлексного тестирования в скрининговых программах предраковых процессов и рака шейки матки The introduction of artificial intelligence technologies in practical medicine is a trend in the present. To objectify the process of differential diagnosis of squamous intraepithelial lesions (SIL). To objectify the process of differentiated diagnosis of squamous intraepithelial lesions (SIL), the possibility of using an automated neural network classifier with denormalized data - the results of expression of the 24 gene panel mRNA in the material of the preserving solution of the Pap test CellPrep (detecting amplifier “DT Prime”) is considered. The classification accuracy of 2 clinically important groups was analyzed: HSIL + and LSIL / benign changes, which will enable this decision-making system to be included in the examination algorithm for patients with squamous intraepithelial lesions and consider this decision-making system as a possible step in reflex testing in screening programs for precancerous processes and cervical cancer

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