Comparison of Colposcopic Biopsy Results of Non-HPV 16/18 Oncogenic Type Positive Patients

Abstract

Objective: This study aimed to evaluate and compare the risk in detecting cervical intraepithelial neoplasia (CIN) 2+ or higher lesions by performing immediate colposcopy in patients with positive high-risk non-human papillomavirus (HPV) 16/18 subtypes, regardless of their cytology results. Material and Methods: A total of 264 patients with HPV-positive subtypes, aged 20-65 years, with any type of cervical cytology results were included in the study. A liquid-based cytologic cervical cancer screening with HPV testing was carried out between November 2020 and May 2021. Cytological specimens were classified according to the Bethesda system (2014), and HPV identification was analyzed with Cobas 4800 system. Colposcopy-guided endocervical curettage and endometrial biopsy were performed. Results: A total of 123 patients had HPV non-16/18 oncogenic types, wherein 34 (69.3%) had no dysplasia, 9 (18.3%) had CIN 1, and 2 (4.08%) had CIN 2-3. Conclusion: Colposcopic evaluation may be considered in cases of non-16/18 high-risk HPV subtypes with abnormal cytologic results. Among the patients who had negative cervical cytology and positive non-HPV-16/18, 4.08% were women with CIN 2-3. Following the algorithm according to the guidelines, there will be a risk of 4.08% of misdiagnosing CIN 2+ lesions by gynecologists. Organizing large-scale randomized controlled studies will help in understanding the meaning or importance of this topic.