Adjunctive Human Papillomavirus Testing in the 2-Year Follow-up of Women With Low-Grade Cervical Cytologic Abnormalities: A Randomized Trial and Economic Evaluation

2003 ◽  
Vol 127 (9) ◽  
pp. 1169-1175 ◽  
Author(s):  
Alice Lytwyn ◽  
John W. Sellors ◽  
James B. Mahony ◽  
Dean Daya ◽  
William Chapman ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Pap Test ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Hpv Testing ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Abstract Context.—Although human papillomavirus (HPV) testing may aid in managing low-grade abnormality on screening cervical cytology, patient compliance with repeat testing programs requires consideration. Objectives.—To determine effectiveness and costs of repeated Papanicolaou (Pap) test and oncogenic HPV testing for detecting cervical intraepithelial neoplasia 2 or 3. Design.—We conducted a randomized controlled trial of combined Pap test and cervical HPV testing by Hybrid Capture 1 test compared with Pap test alone; tests were performed every 6 months for up to 2 years. The study end point was colposcopic examination performed on all women at 2 years, or earlier if an HPV test was positive or if a Pap test showed high-grade squamous intraepithelial lesion. Setting.—Sixty-six community family practices. Participants.—Two hundred fifty-seven women with atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion on screening cervical cytology. Main Outcome Measures.—Detection of histologically confirmed cervical intraepithelial neoplasia 2 or 3, fully allocated costs, and loss to follow-up. Results.—Combined Pap test and HPV testing detected 11 (100%) of 11 cases of cervical intraepithelial neoplasia 2/3, whereas Pap test alone detected 7 (63.6%) of these 11 cases (P = .14); corresponding specificities were 39 (46.4%) of 84 and 45 (71.4%) of 63 (P = .005). The cost-effectiveness ratio was Can $4456 per additional case of high-grade cervical intraepithelial neoplasia. Sixty-nine (26.8%) of the 257 women (24.6% combined group vs 29.1% Pap test only group, P = .41) defaulted from testing or from colposcopy when referred with an abnormal result. Conclusions.—Combined testing was more costly but may detect more cases of cervical intraepithelial neoplasia 2/3 than Pap test alone. However, poor adherence limits usefulness of a management strategy that requires repeated follow-up.

scholarly journals Kanker serviks dan gen Fas-promoter-670

2019 ◽  
Vol 2 (3) ◽  
pp. 90-91
Author(s):  
ML Edy Parwanto
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Incidence Rate ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Intraepithelial Lesion

Kanker serviks merupakan keganasan pada serviks. Jenis kanker tersebut terjadi pada perempuan dan masih menjadi masalah di Indonesia. Indonesia merupakan negara urutan ke 4 di Asia Tenggara dengan insiden kanker serviks terbesar setelah Kamboja, Myanmar dan Thailand. Berdasar data statistik tahun 2012, tingkat insidensi (incidence rate) kanker serviks di Indonesia 17 per 100.000 perempuan per tahun.(1) Telah terbukti bahwa penyebab primer terjadinya kanker serviks yaitu virus papilloma atau yang lebih dikenal dengan istilah “human papillomavirus (HPV)”. Terdapat beberapa jenis serotype HPV, tetapi tidak semua jenis serotype bersifat progesif menjadikan kanker serviks. Salah satu serotype yang bersifat progesif menjadikan kanker serviks yaitu HPV serotype 16. HPV serotype 16 mampu mengubah sel epitel squamosa serviks (cervical-squamous-epithelial cells=CSEC) normal menjadi lesi intraepitelial squamosa tingkat rendah (low-grade squamous intraepithelial lesion=LSIL) atau neoplasia intraepitel serviks (cervical intraepithelial neoplasia=CIN) 1. Selanjutnya, LSIL atau CIN 1 berkembang menjadi lesi intraepitelial squamosa tingkat tinggi (high-grade squamous intraepithelial lesion=HSIL) atau CIN 2, dan akhirnya menjadi kanker serviks yang invasif (invasive cervical cancer=CIN3).(2)

Providing high quality information about human papillomavirus for women after treatment for high-grade cervical dysplasia

Sexual Health ◽  
2010 ◽  
Vol 7 (1) ◽  
pp. 49 ◽  
Author(s):  
Suzanne Dyson ◽  
Marian Pitts ◽  
Anthony Lyons ◽  
Robyn Mullins
Keyword(s):  
Human Papillomavirus ◽  
Information Needs ◽  
Qualitative Interviews ◽  
Cervical Dysplasia ◽  
Pap Test ◽  
Intraepithelial Neoplasia ◽  
General Information ◽  
High Grade ◽  
Hpv Testing

Background: The present study aimed to inform the production of a resource for women who have had a high-grade cervical abnormality and are scheduled to undergo testing for human papillomavirus (HPV) at their 12-month follow-up. Methods: Two rounds of semi-structured, qualitative interviews were held with women who were attending a gynaecological oncology clinic at a major teaching hospital for women in Melbourne, Australia, 6 months after treatment for cervical intraepithelial neoplasia (CIN) to receive a follow-up Pap test and colposcopy. In an initial round of interviews, we gauged the reactions of 16 women to an existing information brochure containing general information about HPV. Based on the findings from the interviews, a second brochure aimed specifically for women scheduled to undergo HPV testing as part of their post treatment follow-up was drafted. Feedback was then gathered from a further 12 women. Results: While all participants had received some information and counselling about HPV and HPV testing as part of their treatment, many still experienced high levels of stress and anxiety about cancer and the sexually transmissible nature of HPV. Many also still had unanswered questions about HPV, their treatment regime and future prognosis. Conclusion: For a brochure to provide an effective adjunct to counselling, it is essential that it is carefully developed and pilot tested to ensure that it is easily understood and meets the information needs of the target audience. Such materials need to provide both medical and psychosocial information about HPV and be presented in accessible, easy to understand language.

scholarly journals Correlation of Histopathologic Follow-up Findings With Vaginal Human Papillomavirus and Low-Grade Squamous Intraepithelial Lesion Papanicolaou Test Results

2011 ◽  
Vol 135 (12) ◽  
pp. 1545-1549 ◽  
Author(s):  
Mona Bansal ◽  
R Marshall Austin ◽  
Chengquan Zhao
Keyword(s):  
Human Papillomavirus ◽  
Low Grade ◽  
Hpv Testing ◽  
Test Results ◽  
Squamous Intraepithelial Lesion ◽  
Papanicolaou Test ◽  
Dna Test ◽  
Correlation Data ◽  
Intraepithelial Lesion

Context.—Data on high-risk human papillomavirus (hrHPV) DNA test results in vaginal, liquid-based cytology (LBC) specimens and corresponding cytologic and histopathologic correlation data are limited. Objective.—To analyze follow-up correlation data associated with vaginal (after hysterectomy) low-grade squamous intraepithelial lesion (LSIL) LBC and hrHPV test results. Design.—Hospital records were searched for vaginal LSIL LBC and hrHPV results between July 1, 2005, and July 30, 2009. Histopathologic and Papanicolaou test follow-up correlation data were analyzed. Results.—During the study period, 2892 patients with test results from both posthysterectomy vaginal LBC and hrHPV were identified: 148 (5.1%) of the patients had vaginal Papanicolaou test results reported as LSIL, with hrHPV detected in 113 of the 148 patients (76.4%). Of 148 patients, 59 of those with vaginal LSIL including 48 (81.4%) with positive HPV testing and 11 (18.6%) with negative HPV testing results had a follow-up vaginal biopsy. Histopathologic vaginal intraepithelial neoplasia (VAIN) 2/3 was diagnosed in 7 of 59 patients (11.9%) with biopsies. In all 7 patients who were diagnosed with VAIN 2/3, hrHPV was detected in the LBC vial. No VAIN 2/3 diagnoses were documented in the biopsy specimens from the 11 patients with hrHPV− LSIL Papanicolaou test results. Histopathologic VAIN 2/3 was diagnosed from vaginal biopsies in 7 of the 48 patients (14.6%) with vaginal hrHPV+ LSIL test results. Conclusions.—Sensitivity and specificity of hrHPV test results associated with histopathologic follow-up diagnoses of VAIN 2/3 in patients with vaginal LSIL results were 100% and 21.2%, respectively. The positive predictive value of a vaginal hrHPV+ LSIL result for a subsequent histopathologic VAIN 2/3 diagnosis was 14.6%. No cases of VAIN 2/3 were diagnosed in the 11 patients with vaginal hrHPV− LSIL results. Correlations of vaginal cytologic, histopathologic, and human papillomavirus findings were quite similar to correlation findings previously reported in older women with cervical LSIL test results.

scholarly journals Integrative and episomal forms of genotype 16 of human papillomavirus in patients with cervical intraepithelial neoplasia and cervical cancer

2016 ◽  
Vol 61 (6) ◽  
pp. 270-274 ◽  
Author(s):  
M. K. Ibragimova ◽  
M. M. Tsyganov ◽  
I. V. Karabut ◽  
O. N. Churuksaeva ◽  
O. N. Shpileva ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Viral Load ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
High Viral Load ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Comprehensive Survey ◽  
Intraepithelial Lesion

The study involved 500 patients with LSIL (low grade squamous intraepithelial lesion), HSIL (high grade squamous intraepithelial lesion), stage I-IV cervical cancer, infected with human papillomavirus (HPV), as well as 235 women without pathological changes in cervical mucosa. The comprehensive survey included colposcopy, cytological and histological analysis, detection and genotyping of high-risk human papillomavirus. Viral load and physical status of HPV16 DNA was evaluated in cases of mono-infection (n = 148). The prevalence of virus-positive cases among the patients with LSIL/NSIL, cervical cancer patients and healthy women was 69.2%, 76.7% and 51.9%, respectively. An association between the severity of disease and high viral load was revealed. The frequency of integrated DNA was strongly increased in patients with a high viral load. The frequency of episomal forms was either reduced or not detecteable in patients with high viral load as compared to patients with low viral load. It is reasonable to suggest that a high HPV16 viral load may cause an increase in the frequency of integration of virus DNA into the cellular/host genome. This suggests that a high HPV16 viral load may be considered as a risk factor for prognosis of cervical intraepithelial neoplasia and cervical cancer.

Significance of Margin and Extent of Dysplasia in Loop Electrosurgery Excision Procedure Biopsies Performed for High-Grade Squamous Intraepithelial Lesion in Predicting Persistent Disease

2007 ◽  
Vol 131 (4) ◽  
pp. 622-624
Author(s):  
Lisa N. Tyler ◽  
Nancy Andrews ◽  
Rudolph S. Parrish ◽  
Linda J. Hazlett ◽  
Soheila Korourian
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Positive Margins ◽  
Biopsy Specimens ◽  
The Status ◽  
Intraepithelial Lesion ◽  
Intraepithelial Lesions

Abstract Context.—High-grade squamous intraepithelial lesions (cervical intraepithelial neoplasia 2 and 3) are commonly treated with loop electrosurgery excision procedure (LEEP) biopsies. Objective.—To highlight the significance of positive margins and extent of positive margins of the cervical LEEP biopsies in predicting the persistence of high-grade squamous intraepithelial lesion and to provide suggestions for reporting margins in cervical LEEP biopsies. Design.—The pathology files at the University of Arkansas for Medical Sciences were searched for cervical intraepithelial neoplasia 2 and 3 treated by LEEP biopsy from 1990 to 2001. Results.—A total of 489 LEEP biopsy specimens were retrieved and reviewed; 270 patients had follow-up within 1 year. The biopsy specimens of 110 patients showed positive endocervical margins. One hundred sixty specimens had negative ectocervical-endocervical margins. Follow-up of 54% of the cases with initial positive margins showed residual high-grade squamous intraepithelial lesions. This association was even greater when multiple blocks showed positive endocervical margins and in cases with positive deep margins. On the other hand, a negative margin predicted ability to completely remove the lesion in 95% of patients. Conclusion.—This study reiterates the significance of the evaluation of the margin, even in samples that were received as multiple fragments. Reporting of LEEP biopsy findings should include the extent of the dysplasia, the status of the ectocervical-endocervical margin, and the status of the deep margin.

scholarly journals Clinical characteristics of single human papillomavirus 53 infection: a retrospective study of 419 cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruizhe Chen ◽  
Yunfeng Fu ◽  
Bingbing You ◽  
Ying Li ◽  
Yeli Yao ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Retrospective Study ◽  
Clinical Characteristics ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Hpv Genotypes ◽  
Intraepithelial Lesion ◽  
Histological Results

Abstract Background Human papillomavirus (HPV) infection is the main cause of cervical cancer. Characteristics of HPV infections, including the HPV genotype and duration of infection, determine a patient’s risk of high-grade lesions. Risk quantification of cervical lesions caused by different HPV genotypes is an important component of evaluation of cervical lesion. Data and evidence are necessary to gain a deeper understanding of the pathogenicity of different HPV genotypes. The present study investigated the clinical characteristics of patients infected with single human papillomavirus (HPV) 53. Methods This retrospective study analyzed the clinical data of patients who underwent cervical colposcopy guided biopsy between October 2015 and January 2021. The clinical outcomes and the follow-up results of the patients with single HPV53 infection were described. Results 82.3% of the initial histological results of all 419 patients with single HPV53 infection showed negative (Neg). The number of patients with cervical intraepithelial neoplasia (CIN)1, CIN2, CIN3, vaginal intraepithelial neoplasia (VaIN)1, CIN1 + VaIN1, CIN1 + VaIN2, and CIN2 + VaIN2 was 45, 10, 2, 9, 6, 1, and 1, respectively. Cancer was not detected in any patient. When the cytology was negative for intraepithelial lesion or malignancy (NILM), atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL), we observed a significant difference in the distribution of histological results (P < 0.05). 95 patients underwent follow-up with cytology according to the exclusion criteria. No progression of high-grade lesions was observed during the follow-up period of 3–34 months. Conclusions The lesion caused by HPV53 infection progressed slowly. The pathogenicity of a single HPV53 infection was low.

HLA Class II DRB1*1302 Allele Protects Against Progression to Cervical Intraepithelial Neoplasia Grade 3: A Multicenter Prospective Cohort Study

2012 ◽  
Vol 22 (3) ◽  
pp. 471-478 ◽  
Author(s):  
Koji Matsumoto ◽  
Hiroo Maeda ◽  
Akinori Oki ◽  
Naoyoshi Takatsuka ◽  
Toshiharu Yasugi ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Intraepithelial Neoplasia ◽  
Class Ii ◽  
Hla Class Ii ◽  
Low Grade ◽  
Squamous Intraepithelial Lesion ◽  
Normal Cytology ◽  
Intraepithelial Lesion ◽  
Hla Class Ii Alleles

ObjectiveGenetic variations in human leukocyte antigens (HLA) class II regions may influence the risk of cervical cancer by altering the efficiency of the immune responses to human papillomavirus antigens. This prospective study was designed to evaluate the effects of HLA class II alleles on the natural course of cervical precursor lesions.MethodsWe followed a total of 454 Japanese women with cytological low-grade squamous intraepithelial lesion (LSIL) and histological cervical intraepithelial neoplasia grades 1 to 2 (CIN1-CIN2). Patients were tested for HLA class II alleles and cervical human papillomavirus DNA at the time of entry and then monitored by cytology and colposcopy every 4 months for a mean follow-up of 39.0 months. We analyzed cumulative probabilities of cytological regression to at least 2 consecutive negative Papanicolaou tests and histological progression to biopsy-positive CIN3.ResultsDuring the follow-up period, 39 lesions progressed to CIN3, and 282 lesions regressed to normal cytology. Progression to CIN3 did not occur in DRB1*1302-positive women, and this protective effect of DRB1*1302 was statistically significant (P = 0.03). Low-grade squamous intraepithelial lesion regressed to normal cytology more quickly in DRB1*1302-positive women than in DRB1*1302-negative women (median time, 8.9 months vs 14.2 months), although the difference was not statistically significant (P = 0.16). The risk of LSIL persistence or progression to CIN3 within 5 years was not affected by any other HLA class II alleles.ConclusionBy using a prospective study design, we demonstrated the protective effect of the DRB1*1302 allele against progression to CIN3 among Japanese women with LSIL.

Sign in / Sign up

Export Citation Format

Share Document