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Comparison of human papillomavirus distribution in cytologic subgroups of low-grade squamous intraepithelial lesion.
Cancer. 2006 Oct 25; 108(5):288-97.C

Abstract

BACKGROUND

Low-grade squamous intraepithelial lesion (LSIL) subsumes the formerly delineated cytologic categories of human papillomavirus (HPV)-associated cell changes (koilocytotic atypia) and low-grade dysplasia/cervical intraepithelial neoplasia (CIN) Grade 1 (CIN1). In this study, the objective was to determine whether these 2 morphologic subcategories are characterized by differences in risk for CIN3 and/or HPV type distribution.

METHODS

Within the Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesion Triage Study, all cytologic interpretations of HPV cellular changes and CIN1 rendered by any of the pathology reviewers (community laboratory, clinical center, or Pathology Quality-Control Group) on referral Papanicolaou (Pap) tests or enrollment ThinPrep Pap tests were included for analysis. HPV testing was performed by Hybrid Capture 2 (HC2) and by polymerase chain reaction based reverse-line blot analysis for 27 HPV types. The absolute risks of cumulative detection of CIN3 or cancer (CIN3 +) and CIN2 or worse (CIN2 +) over 2 years of follow-up were calculated for the various cytologic interpretations.

RESULTS

For each review group and cytology preparation, most LSIL interpretations (from approximately 2 of 3 interpretations to 3 of 4 interpretations) were subcategorized as CIN1 rather than HPV cellular changes. HPV type 16 (HPV-16) was the most common HPV type and was identified in 21% to 24% of CIN1 and in 14% to 18% of HPV cellular changes. Nononcogenic types were identified alone in from 9% to 11% of CIN1 compared with 17% to 20% of HPV cellular change. The absolute risks of CIN1 and HPV cellular changes for cumulatively detected CIN3 + ranged from 12% to 16% for CIN1 and from 6% to 9% for HPV cellular changes.

CONCLUSIONS

Both cytologic subcategories of LSIL were associated predominantly with oncogenic HPV types; however, the proportion of nononcogenic HPV types was lower and the absolute risks for CIN3 + were higher for CIN1 compared with HPV cellular changes. The concordance in subcategorizing LSIL was low, and the authors concluded that the diagnostic distinction is of limited clinical utility for individual patient management.

Authors+Show Affiliations

Pathology Department, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. rosemary-zuna@ouhsc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

16952155

Citation

Zuna, Rosemary E., et al. "Comparison of Human Papillomavirus Distribution in Cytologic Subgroups of Low-grade Squamous Intraepithelial Lesion." Cancer, vol. 108, no. 5, 2006, pp. 288-97.
Zuna RE, Wang SS, Schiffman M, et al. Comparison of human papillomavirus distribution in cytologic subgroups of low-grade squamous intraepithelial lesion. Cancer. 2006;108(5):288-97.
Zuna, R. E., Wang, S. S., Schiffman, M., & Solomon, D. (2006). Comparison of human papillomavirus distribution in cytologic subgroups of low-grade squamous intraepithelial lesion. Cancer, 108(5), 288-97.
Zuna RE, et al. Comparison of Human Papillomavirus Distribution in Cytologic Subgroups of Low-grade Squamous Intraepithelial Lesion. Cancer. 2006 Oct 25;108(5):288-97. PubMed PMID: 16952155.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of human papillomavirus distribution in cytologic subgroups of low-grade squamous intraepithelial lesion. AU - Zuna,Rosemary E, AU - Wang,Sophia S, AU - Schiffman,Mark, AU - Solomon,Diane, PY - 2006/9/5/pubmed PY - 2006/12/9/medline PY - 2006/9/5/entrez SP - 288 EP - 97 JF - Cancer JO - Cancer VL - 108 IS - 5 N2 - BACKGROUND: Low-grade squamous intraepithelial lesion (LSIL) subsumes the formerly delineated cytologic categories of human papillomavirus (HPV)-associated cell changes (koilocytotic atypia) and low-grade dysplasia/cervical intraepithelial neoplasia (CIN) Grade 1 (CIN1). In this study, the objective was to determine whether these 2 morphologic subcategories are characterized by differences in risk for CIN3 and/or HPV type distribution. METHODS: Within the Atypical Squamous Cells of Undetermined Significance/Low-Grade Squamous Intraepithelial Lesion Triage Study, all cytologic interpretations of HPV cellular changes and CIN1 rendered by any of the pathology reviewers (community laboratory, clinical center, or Pathology Quality-Control Group) on referral Papanicolaou (Pap) tests or enrollment ThinPrep Pap tests were included for analysis. HPV testing was performed by Hybrid Capture 2 (HC2) and by polymerase chain reaction based reverse-line blot analysis for 27 HPV types. The absolute risks of cumulative detection of CIN3 or cancer (CIN3 +) and CIN2 or worse (CIN2 +) over 2 years of follow-up were calculated for the various cytologic interpretations. RESULTS: For each review group and cytology preparation, most LSIL interpretations (from approximately 2 of 3 interpretations to 3 of 4 interpretations) were subcategorized as CIN1 rather than HPV cellular changes. HPV type 16 (HPV-16) was the most common HPV type and was identified in 21% to 24% of CIN1 and in 14% to 18% of HPV cellular changes. Nononcogenic types were identified alone in from 9% to 11% of CIN1 compared with 17% to 20% of HPV cellular change. The absolute risks of CIN1 and HPV cellular changes for cumulatively detected CIN3 + ranged from 12% to 16% for CIN1 and from 6% to 9% for HPV cellular changes. CONCLUSIONS: Both cytologic subcategories of LSIL were associated predominantly with oncogenic HPV types; however, the proportion of nononcogenic HPV types was lower and the absolute risks for CIN3 + were higher for CIN1 compared with HPV cellular changes. The concordance in subcategorizing LSIL was low, and the authors concluded that the diagnostic distinction is of limited clinical utility for individual patient management. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/16952155/Comparison_of_human_papillomavirus_distribution_in_cytologic_subgroups_of_low_grade_squamous_intraepithelial_lesion_ L2 - https://doi.org/10.1002/cncr.22168 DB - PRIME DP - Unbound Medicine ER -