Analysis of cervical liquid-based cytology results in Eskişehir, Turkey: correlation of cytology results with histology, immunocytocemical HPV Ab and HPV DNA results of 18404 women

Background: To analyze retrospectively the results of HPV DNA, immunocytochemical HPV antibody staining of gynecologic smear samples evaluated in a public hospital and to observe their compatibility with histologic diagnosis. At the same time, the contribution of ICC HPV Ab staining experience results to the morphological evaluation is discussed in this paper.Methods: In this study, liquid-based cytology test results of patients who applied to the gynecology between 2014 and 2017 were analyzed. The Ultravision Quanto Detection System was modified for immunocytochemical staining. HPV DNA tests were performed with the Qiagen Hybrid Capture test.Results: The 18404 test result was included in the research. The percentage of smear that epithelial cell atypia is seen was 3.4%, the rate of ASC/SIL was 1.89%. Compared to the first 3 years of the study, the increase in the rate of LSIL is seen with a partial decrease in ASCUS rate in year 2017 (p<0.05). The atypical positive test rate with histologic confirmation was 73.61%. Among 138 HPV Ab results, 58.7% of them were negative and 41.3% of them were positive. Sensitivity and specificity rates were determined 76.19% and 52.17% for SIL. Among 53 HPV DNA results (53% negative and 46.3% positive); sensitivity and specificity rates were determined 92.86% and 50% for SIL.Conclusions: İmmunocytochemical HPV Ab staining provided statistically significant contribution to LSIL (p<0.05). It is thought that it also will provide additional evidence for morphological findings while cytological evaluation and may help the clinician in managing the conditions for disease.

Human papillomaviruses 16 and 58 are distributed widely among women living in Shanghai, China, with high-grade, squamous intraepithelial lesions

The distribution of human papillomaviruses (HPVs) must be understood for the control and prevention of cervical cancer. Community-based Papanicolaou and HPV DNA tests were performed on 41 578 women. The prevalences of HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68 were assessed. In total, 10% women were infected/co-infected by these HPVs. The infection rate increased from 7.1% in women aged ⩽30 years to 10.4% in those aged 50–60 years, and then decreased slightly to 9.9% in those aged >60 years. The HPV 16 and 58 positivity rates were significantly higher among women with high-grade squamous intraepithelial lesions (HSILs) than among those with cervicitis/negativity for intraepithelial lesion or malignancy (NILM) or low-grade SILs (LSILs). The HPV 18, 52 and 68 infection rates were significantly lower in women with HSILs than in those with NILM or LSILs. The proportion of women infected by multiple HPV strains was higher among those with HSILs. The proportions of the five most common genotypes, HPV 16, 18, 33, 52 and 58, increased with the number of co-infecting strains. HPV 16 and 58 were the high-risk HPVs in the Shanghai community and should be the focus in HPV screening and vaccination.

Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil

Evidence-based clinical guidelines ensure best practice protocols are available in health care. There is a widespread use of human papillomavirus deoxyribonucleic acid (HPV-DNA) tests in Brazil, regardless of the lack of official guidelines. On behalf of the Brazilian Association for the Lower Genital Tract Pathology and Colposcopy (ABPTGIC, in the Portuguese acronym), a team of reviewers searched for published evidence and developed a set of recommendations for the use of HPV-DNA tests in cervical cancer screening in Brazil. The product of this process was debated and consensus was sought by the participants. One concern of the authors was the inclusion of these tests in the assessment of women with cytologic atypia and women treated for cervical intraepithelial neoplasia (CIN). Testing for HPV is recommended in an organized screening scenario to identify women with precursor lesions or asymptomatic cervical cancer older than 30 years of age, and it can be performed every 5 years. It also has value after the cytology showing atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSILs) as a triage test for colposcopy, in the investigation of other cytological alterations when no abnormal findings are observed at colposcopy, seeking to exclude disease, or, further, after treatment of high-grade cervical intraepithelial neoplasia, to rule out residual disease.