The significance of extensive HPV genotyping for cervical high-grade neoplasia among women with atypical glandular cells.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS

ACS Applied Bio Materials Pub Date : 2024-08-07 DOI:10.1093/ajcp/aqae103

Xiao Tang, Megan L Zilla, Wei Jiang, Yanmei He, David Starr, Lei Li, Lingling Tong, Cheng Wang, Wei Wang, Kaixuan Yang, Rutie Yin, Chengquan Zhao

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Abstract

Objectives: To examine the associated risk of cervical intraepithelial neoplasm grade 3+ (CIN3+) lesions in patients with AGC and extensive human papillomavirus (HPV) genotyping.

Methods: Cases with atypical glandular cell (AGC) interpretation on a Papanicolaou (Pap) test were identified along with associated extensive HPV genotyping and histologic follow-up results.

Results: Within this cohort of 469,694 Pap tests, 0.4% were diagnosed as AGCs. In total, 1267 cases had concurrent high-risk HPV (hrHPV) genotyping, and 40.3% were hrHPV positive. The percentage of AGC cases with cervical CIN3+ on histologic follow-up was 52.2% when hrHPV was positive, whereas it was 4.9% with a negative hrHPV result. The top 5 hrHPV genotypes associated with cervical CIN3+ in this cohort were HPV16, HPV18, HPV58, HPV52, and HPV33. Indeed, 92.8% of the hrHPV-associated CIN3+ lesions identified in this cohort were positive for at least one of these HPV genotypes. The sensitivity of detecting cervical CIN3+ lesions was 85.6% with the top 5 hrHPV genotypes (HPV16/18/58/52/33) and only increased to 89.0% when the additional 12 genotypes were included.

Conclusions: In patients with an AGC Pap, the risk of having a cervical CIN3+ lesion is greatly increased by positivity for hrHPV types 16, 18, 58, 52, and/or 33. Incorporating comprehensive HPV genotyping into AGC cytology allows for refined risk stratification and more tailored management strategies.

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对患有非典型腺细胞的妇女进行广泛的 HPV 基因分型对宫颈高级别肿瘤的意义。

目的研究AGC和广泛人乳头瘤病毒（HPV）基因分型患者发生宫颈上皮内瘤变3级+（CIN3+）病变的相关风险：方法：对巴氏试验（Pap）结果显示为非典型腺细胞（AGC）的病例进行鉴定，并同时进行广泛的人乳头瘤病毒（HPV）基因分型和组织学随访：在 469,694 例帕氏试验中，0.4% 被诊断为 AGC。共有 1267 例病例同时进行了高危 HPV（hrHPV）基因分型，其中 40.3% 为 hrHPV 阳性。在组织学随访中，hrHPV 阳性的 AGC 病例中宫颈 CIN3+ 的比例为 52.2%，而 hrHPV 阴性的比例为 4.9%。在该队列中，与宫颈 CIN3+ 相关的前 5 种 hrHPV 基因型是 HPV16、HPV18、HPV58、HPV52 和 HPV33。事实上，在该队列中发现的与 hrHPV 相关的 CIN3+ 病变中，92.8%至少有一种 HPV 基因型呈阳性。前5种hrHPV基因型（HPV16/18/58/52/33）检测宫颈CIN3+病变的灵敏度为85.6%，当包括其他12种基因型时，灵敏度才提高到89.0%：结论：在接受AGC巴氏检查的患者中，hrHPV 16、18、58、52和/或33型阳性会大大增加宫颈CIN3+病变的风险。在 AGC 细胞学检查中纳入全面的 HPV 基因分型可进行精细的风险分层，并制定更有针对性的管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Bio Materials Chemistry-Chemistry (all)

CiteScore

9.40

自引率

2.10%

发文量

464