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1. Atypical squamous cells of undetermined significance in patients with HPV positive DNA testing and correlation with disease progression by age group: an institutional experience

Author

Rodriguez, Erika F, Reynolds, Jordan P, Jenkins, Sarah M, Winter, Stephanie M, Henry, Michael R, and Nassar, Aziza

Subjects
Adult, Vaginal Smears, Papillomavirus Infections, Uterine Cervical Neoplasms, Adenocarcinoma, Middle Aged, Prognosis, Uterine Cervical Dysplasia, Molecular Diagnostic Techniques, DNA, Viral, Disease Progression, Humans, Original Article, Female, Papillomaviridae, Aged
Abstract

Atypical squamous cells of undetermined significance (ASC-US) is a broad diagnostic category that could be attributed to human papillomavirus infection (HPV), malignant neoplasia and reactive conditions. We evaluated our institutional experience with ASC-US in women who are positive for high risk HPV (HRHPV+) by the Digene hybrid capture method from 2005-2009 to identify the risk of progression to squamous intraepithelial lesion (SIL) and cervical intraepithelial neoplasia (CIN) in association with age. We reviewed cytologic and follow-up surgical pathology reports for all specimens available. Progression was defined as a diagnosis of at least CINI on follow-up biopsy or resection or SIL on cytology. We identified 2613 cases and follow-up was available in 1839 (70.4%). Of these 74.2% had just one follow-up, 16.2% had a total of 2 follow-ups, 5.3% had a total of 3 follow-ups, and the remaining had as many as 6 follow-ups. Among the 1839 patients, 69.4% were age 30 or younger, 16.0% were between 31 to 40, 9.0% were between 41 to 50, and 5.6% were 51 or older. Among these, 25-30% progressed to dysplasia. The risk of progression varied by age (p=0.04) and was lowest among women between the ages of 41-50. Our findings highlight the importance of continued cytologic follow-up in women with HRHPV+ ASC-US in order to detect progression of disease, although the risk of progression is age dependent.

Published
2012

2. Atypical squamous cells of undetermined significance in patients with HPV positive DNA testing and correlation with disease progression by age group: an institutional experience.

Author

Rodriguez EF, Reynolds JP, Jenkins SM, Winter SM, Henry MR, and Nassar A

Subjects
Adenocarcinoma virology, Adult, Aged, DNA, Viral analysis, Disease Progression, Female, Humans, Middle Aged, Molecular Diagnostic Techniques, Papillomaviridae isolation & purification, Papillomavirus Infections complications, Prognosis, Uterine Cervical Dysplasia virology, Uterine Cervical Neoplasms virology, Vaginal Smears, Adenocarcinoma diagnosis, DNA, Viral genetics, Papillomaviridae genetics, Papillomavirus Infections diagnosis, Uterine Cervical Dysplasia diagnosis, Uterine Cervical Neoplasms diagnosis
Abstract

Atypical squamous cells of undetermined significance (ASC-US) is a broad diagnostic category that could be attributed to human papillomavirus infection (HPV), malignant neoplasia and reactive conditions. We evaluated our institutional experience with ASC-US in women who are positive for high risk HPV (HRHPV+) by the Digene hybrid capture method from 2005-2009 to identify the risk of progression to squamous intraepithelial lesion (SIL) and cervical intraepithelial neoplasia (CIN) in association with age. We reviewed cytologic and follow-up surgical pathology reports for all specimens available. Progression was defined as a diagnosis of at least CINI on follow-up biopsy or resection or SIL on cytology. We identified 2613 cases and follow-up was available in 1839 (70.4%). Of these 74.2% had just one follow-up, 16.2% had a total of 2 follow-ups, 5.3% had a total of 3 follow-ups, and the remaining had as many as 6 follow-ups. Among the 1839 patients, 69.4% were age 30 or younger, 16.0% were between 31 to 40, 9.0% were between 41 to 50, and 5.6% were 51 or older. Among these, 25-30% progressed to dysplasia. The risk of progression varied by age (p=0.04) and was lowest among women between the ages of 41-50. Our findings highlight the importance of continued cytologic follow-up in women with HRHPV+ ASC-US in order to detect progression of disease, although the risk of progression is age dependent.

Published
2012

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