open access

Vol 88, No 5 (2017)
Research paper
Published online: 2017-05-31
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Cytohistological discrepancies of cervico-vaginal smears and HPV status

İbrahim Alanbay1, Mustafa Öztürk2, Fahri Burçin Fıratlıgil3, Kazım Emre Karaşahin1, Müfit Cemal Yenen1, Serkan Bodur1
DOI: 10.5603/GP.a2017.0044
·
Pubmed: 28580567
·
Ginekol Pol 2017;88(5):235-238.
Affiliations
  1. Gulhane Military Medical Faculty, Department of Obstetrics and Gynecology, Etlik-Ankara, Turkey, Turkey
  2. Etimesgut Military Hospital, Department of Obstetrics and Gynecology, Etlik-Ankara, Turkey
  3. Hakkari Military Hospital, Department of Obstetrics and Gynecology, Hakkari, Turkey

open access

Vol 88, No 5 (2017)
ORIGINAL PAPERS Gynecology
Published online: 2017-05-31

Abstract

Objectives: Discrepancies between abnormal cervical cytology or high-risk human papillomavirus (HR-HPV) status (cytolo-gy negative/HPV positive) and subsequent histological findings are a common occurrence. After using co-testing, the dis­crepancies between the HR-HPV status and cervical cytology have become an issue. In this study, we aimed to determine the characteristics of women with a discrepancy between histology and cytology/HR-HPV status, in terms of diagnosis, review and identification.

Material and methods: A total of 52 women, patients of the University Hospital between 2013–2015, with cytohistologi­cal or HR-HPV status discrepancy were recruited for the study and retrospectively analyzed. The cytological samples were liquid-based Pap smears, classified according to the 2001 Bethesda system. The HR-HPV status was identified using the Hybrid Capture 2 HR-HPV DNA assay. The histological samples were obtained by cervical biopsy as well as large loop exci­sion of the transformation zone (LLETZ).

Results: A cytohistological discrepancy was demonstrated in patients with (-)cytology/HR-HPV(+), ASCUS, LSIL, ASC-H, HSIL, AGC-NOS: 17.3%, 23.07%, 26.9%, 9.5%, 17.3% and 5.7%, respectively. When the degree of atypia in cytology increases, the concurrency of cervical cytology with biopsy also increases. A positive HR-HPV co-test result (19/24, 79.1%) was observed in nearly all CIN2 ≥ (+) cases. Our study emphasizes the significance of HR-HPV testing to determine CIN2 ≥ (+) cases, even in the presence of a normal cytological result.

Conclusions: In case of cytohistological or HR-HPV discrepancies, a careful review of the HR-HPV status and the degree of cytological atypia should be performed before further intervention.

Abstract

Objectives: Discrepancies between abnormal cervical cytology or high-risk human papillomavirus (HR-HPV) status (cytolo-gy negative/HPV positive) and subsequent histological findings are a common occurrence. After using co-testing, the dis­crepancies between the HR-HPV status and cervical cytology have become an issue. In this study, we aimed to determine the characteristics of women with a discrepancy between histology and cytology/HR-HPV status, in terms of diagnosis, review and identification.

Material and methods: A total of 52 women, patients of the University Hospital between 2013–2015, with cytohistologi­cal or HR-HPV status discrepancy were recruited for the study and retrospectively analyzed. The cytological samples were liquid-based Pap smears, classified according to the 2001 Bethesda system. The HR-HPV status was identified using the Hybrid Capture 2 HR-HPV DNA assay. The histological samples were obtained by cervical biopsy as well as large loop exci­sion of the transformation zone (LLETZ).

Results: A cytohistological discrepancy was demonstrated in patients with (-)cytology/HR-HPV(+), ASCUS, LSIL, ASC-H, HSIL, AGC-NOS: 17.3%, 23.07%, 26.9%, 9.5%, 17.3% and 5.7%, respectively. When the degree of atypia in cytology increases, the concurrency of cervical cytology with biopsy also increases. A positive HR-HPV co-test result (19/24, 79.1%) was observed in nearly all CIN2 ≥ (+) cases. Our study emphasizes the significance of HR-HPV testing to determine CIN2 ≥ (+) cases, even in the presence of a normal cytological result.

Conclusions: In case of cytohistological or HR-HPV discrepancies, a careful review of the HR-HPV status and the degree of cytological atypia should be performed before further intervention.

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Keywords

cervical cytology, cytology/HR-HPV discrepancy, cytological atypia

About this article
Title

Cytohistological discrepancies of cervico-vaginal smears and HPV status

Journal

Ginekologia Polska

Issue

Vol 88, No 5 (2017)

Article type

Research paper

Pages

235-238

Published online

2017-05-31

DOI

10.5603/GP.a2017.0044

Pubmed

28580567

Bibliographic record

Ginekol Pol 2017;88(5):235-238.

Keywords

cervical cytology
cytology/HR-HPV discrepancy
cytological atypia

Authors

İbrahim Alanbay
Mustafa Öztürk
Fahri Burçin Fıratlıgil
Kazım Emre Karaşahin
Müfit Cemal Yenen
Serkan Bodur

References (17)
  1. Skaggs V, Moore K, Stowell S, et al. A LEEP cervical conization is rarely indicated for a two-step discrepancy. J Low Genit Tract Dis. 2007; 11(3): 134–137.
  2. Cho H, Kim JH. Treatment of the patients with abnormal cervical cytology: a. J Gynecol Oncol. 2009; 20(3): 164–168.
  3. Li ZG, Qian deY, Cen JM, et al. Three-step versus “see-and-treat” approach in women with high-grade squamous intraepithelial lesions in a low-resource country. Int J Gynaecol Obstet, 2009;106: 202. 2009; 106(3): 202–205.
  4. Kirby TO, Leath CA. 3rd, Huh WK, Alvarez RD, Straughn JM Jr. A prospective evaluation of “see and treat” in women with HSIL Pap smear results: is this an appropriate strategy? J Low Genit Tract Dis, 2005, 9: 2. ; 6.
  5. Moss EL, Moran A, Douce G, et al. Cervical cytology/histology discrepancy: a 4-year review of patient outcome. Cytopathology. 2010; 21(6): 389–394.
  6. Massad LS, Einstein MH, Huh WK, et al. 2012 ASCCP Consensus Guidelines Conference. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol. 2013; 121(4): 829–846.
  7. Tritz DM, Weeks JA, Spires SE, et al. Etiologies for non-correlating cervical cytologies and biopsies. Am J Clin Pathol. 1995; 103(5): 594–597.
  8. Izadi-Mood N, Sarmadi S, Sanii S. Quality control in cervicovaginal cytology by cytohistological correlation. Cytopathology. 2013; 24(1): 33–38.
  9. Turkmen I, Bassullu N, Korkmaz P, et al. Patients with epithelial cell abnormality in pap smears: correlation of results with follow-up smears andcervical biopsies. Turkish Journal of Pathology. 2013.
  10. Heatley MK, Bury JP. The correlation between the grade of dyskaryosis on cervical smear, grade of cervical intraepithelial neoplasia (CIN) on punch biopsy and the final histological diagnosis on cone biopsies of the cervix. Cytopathology. 1998; 9(2): 93–99.
  11. Moss EL, Hadden P, Douce G, et al. Is the colposcopically directed punch biopsy a reliable diagnostic test in women with minor cytological lesions? J Low Genit Tract Dis. 2012; 16(4): 421–426.
  12. Baldauf JJ, Dreyfus M, Ritter J, et al. An analysis of the factors involved in the diagnostic accuracy of colposcopically directed biopsy. Acta Obstetricia et Gynecologica Scandinavica. 1997; 76(5): 468–473.
  13. Chappatte OA, Byrne DL, Raju KS, et al. Histological differences between colposcopic-directed biopsy and loop excision of the transformation zone (LETZ): a cause for concern. Gynecol Oncol. 1991; 43(1): 46–50.
  14. Marel Jv, Berkhof J, Ordi J, et al. Attributing Oncogenic Human Papillomavirus Genotypes to High-grade Cervical Neoplasia. The American Journal of Surgical Pathology. 2015; 39(4): 496–504.
  15. Bosch FX, Manos MM, Muñoz N, et al. Prevalence of human papillomavirus in cervical cancer: a worldwide perspective. International biological study on cervical cancer (IBSCC) Study Group. J Natl Cancer Inst. 1995; 87(11): 796–802.
  16. Wright TC, Stoler MH, Behrens CM, et al. The ATHENA human papillomavirus study: design, methods, and baseline results. Am J Obstet Gynecol. 2012; 206(1): 46.e1–46.e11.
  17. Louvanto K, Chevarie-Davis M, Ramanakumar AV, et al. HPV testing with cytology triage for cervical cancer screening in routine practice. Am J Obstet Gynecol. 2014; 210(5): 474.e1–474.e7.

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