Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Histologic Outcomes in HPV-Positive and Cervical Cytology-Negative Women - Screening Results in Northern Thailand

  • Vijakururote, Linlada (Division of Gynecologic Pathology, Department of Pathology Faculty of Medicine, Chiang Mai University) ;
  • Suprasert, Prapaporn (Division of Gynecologic Pathology, Department of Pathology Faculty of Medicine, Chiang Mai University) ;
  • Srisomboon, Jatupol (Division of Gynecologic Pathology, Department of Pathology Faculty of Medicine, Chiang Mai University) ;
  • Siriaunkgul, Sumalee (Division of Gynecologic Pathology, Department of Pathology Faculty of Medicine, Chiang Mai University) ;
  • Settakorn, Jongkolnee (Division of Gynecologic Pathology, Department of Pathology Faculty of Medicine, Chiang Mai University) ;
  • Rewsuwan, Sunida (Division of Gynecologic Pathology, Department of Pathology Faculty of Medicine, Chiang Mai University)
  • Published : 2015.11.04
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Abstract

The objective of this study was to determine the prevalence of significant lesions defined as high grade squamous intraepithelial lesions (HSIL), adenocarcinoma in situ (AIS) and invasive carcinoma in women who had HPV-positive and cytology negative co-testing screening results. This retrospective study was conducted in Chiang Mai University Hospital between May, 2013 and August, 2014. Hybrid capture 2 (HC2) was used for HPV testing and conventional Pap smears for cytologic screening. A repeat liquid-based cytology (LBC) was performed in women with such co-testing results followed by colposcopy. Random biopsy was performed in cases of normal colposcopic findings. Further investigations were carried out according to the biopsy or the repeat LBC results. During the study period, 273 women met the criteria and participated in the study. The mean age of these women was 46.4 years with 30% of them reporting more than one partner. The median interval time to colposcopy was 165 days. About 40% showed an abnormality in the repeat cytology. Significant cervical lesions were found in 20 (7.3%) women, including 2 invasive cancers. Of interest was that only 2 of 20 significant lesions were diagnosed by colposcopic examination while the remainder were initially detected by cervical biopsy and abnormal repeat cytology. In conclusion, the prevalence of significant cervical lesions in HPV positive and cytology negative women in Northern Thailand was 7.3%. Further diagnostic work up with repeat cytology follow by colposcopy is recommended. Random biopsy should be performed even when the colposcopic findings are normal.

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References

  1. Andersson S, Mints M, Wilander E (2013). Results of cytology and high-risk human papillomavirus testing in females with cervical adenocarcinoma. Oncol Lett, 6, 215-9.
  2. Arbyn M, Ronco G, Anttila A, et al (2012). Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Vaccine, 30, 88-99. https://doi.org/10.1016/j.vaccine.2012.06.095
  3. Ault KA, Joura EA, Kjaer SK, et al (2011). Adenocarcinoma in situ and associated human papillomavirus type distribution observed in two clinical trials of a quadrivalent human papillomavirus vaccine. Int J Cancer, 128, 1344-53. https://doi.org/10.1002/ijc.25723
  4. Bosch FX, Lorincz A, Muñoz N, et al (2001). The causal relation between human papillomavirus and cervical cancer. J Clin Pathol, 55, 244-65.
  5. Ghosh I, Mittal S, Banerjee D, et al (2014). Study of accuracy of colposcopy in VIA and HPV detection-based cervical cancer screening program. Aust N Z J Obstet Gynaecol, 54, 570-5. https://doi.org/10.1111/ajo.12282
  6. Katki HA, Kinney WK, Fetterman B, et al (2011). Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: a populationbased study in routine clinical practice. Lancet Oncol, 12, 663-72. https://doi.org/10.1016/S1470-2045(11)70145-0
  7. Kietpeerakool C, Srisomboon J, Prompittayarat W, et al (2006). Can adenocarcinoma in situ of the uterine cervix be predicted before cervical conization? Asian Pac J Cancer Prev, 7, 522-4.
  8. Paengchit K, Kietpeerakool C, Wangchai W, et al (2014). Cervical pathology in cytology-negative/HPV-positive women: results from Lampang Cancer Hospital, Thailand. Asian Pac J Cancer Prev, 15, 7951-54. https://doi.org/10.7314/APJCP.2014.15.18.7951
  9. Song Y, Zhao YQ, Zhang X, et al (2015). Random biopsy in colposcopy-negative quadrant is not effective in women with positive colposcopy in practice. Cancer Epidemiol, 39, 237-41. https://doi.org/10.1016/j.canep.2015.01.008
  10. Supho B, Supoken A, Kleebkaew P, et al (2014). Cervical pathology in high-risk human papillomavirus- positive, cytologically normal women. Asian Pac J Cancer Prev, 15, 7977-80. https://doi.org/10.7314/APJCP.2014.15.18.7977
  11. Saslow D, Solomon D, Lawson HW, et al (2012). American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin, 62, 147-72. https://doi.org/10.3322/caac.21139
  12. de Sanjose S, Quint WG, Alemany L, et al (2010). Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol, 11, 1048-56. https://doi.org/10.1016/S1470-2045(10)70230-8
  13. Siriaunkgul S, Suwiwat S, Settakorn J, et al (2008). HPV genotyping in cervical cancer in Northern Thailand: adapting the linear array HPV assay for use on paraffin-embedded tissue. Gynecol Oncol, 108, 555-60. https://doi.org/10.1016/j.ygyno.2007.11.016
  14. Thrall MJ, Russell DK, Facik MS, et al (2010). High-risk HPV testing in women 30 years or older with negative Papanicolaou tests: initial clinical experience with 18-month follow-up. Am J Clin Pathol, 133, 894-8. https://doi.org/10.1309/AJCPAZV88VIFZSFD
  15. Wright TC Jr, Stoler MH, Behrens CM, et al (2012). The ATHENA human papillomavirus study: design, methods, and baseline results. Am J Obstet Gynecol, 206, 1-46. https://doi.org/10.1016/j.ajog.2011.10.025
  16. Wright TC Jr, Stoler MH, Sharma A, et al (2011). Evaluation of HPV-16 and HPV-18 genotyping for the triage of women with high-risk HPV+ cytology-negative results. Am J Clin Pathol, 136, 578-86. https://doi.org/10.1309/AJCPTUS5EXAS6DKZ
  17. Yang B, Pretorius RG, Belinson JL, et al (2008). False negative colposcopy is associated with thinner cervical intraepithelial neoplasia 2 and 3. Gynecol Oncol, 110, 32-6 https://doi.org/10.1016/j.ygyno.2008.03.003