Cytology Triage for HPV-Positive Postmenopausal Women in a Setting of Cervical Cancer Screening

IF 1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Diagnostic Cytopathology Pub Date : 2025-02-26 DOI:10.1002/dc.25456

Aparna Chacko, Vishaka C. Bidkar, Geeta Acharya, Julian Crasta

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引用次数: 0

Abstract

Background

Globally, cervical cytology continues to serve as the cornerstone of cervical cancer screening programs, but WHO 2021 guidelines advocate HPV DNA testing as the primary screening modality due to its heightened sensitivity. This method necessitates additional triage with cytology or colposcopy to detect precancerous lesions. Hormonal shifts and anatomical alterations in postmenopausal women may impact diagnostic outcomes in either modality.

Aim

To describe the spectrum of cytological lesions in HPV-positive postmenopausal women to detect precancerous lesions as part of cervical cancer screening.

Methods

Conventional cytology smears of high-risk HPV-positive postmenopausal women were reported according to The Bethesda System 2014. Results of follow-up biopsies of the positive smears were recorded, and cyto-histological correlation was performed.

Results

The retrospective study included conventional cytology smears of 124 postmenopausal women positive for high-risk HPV DNA with a mean age of 52 years. Of the 124 cases, 68 were positive for HPV 16 and/or 18, and 56 were positive for other high-risk HPV. On cytology, 78% were negative for intraepithelial lesions. HSIL+ lesions were noted in 12%, and low-grade lesions were noted in 10% of smears with HPV16/18 predominance. Follow-up biopsies of 17 smears revealed SCC in two cases, HSIL+ in 11 cases, LSIL in 2, and 2 were negative/benign lesions. Of the cyto-histological discordant cases, four were upgraded on review.

Conclusion

Cytology is a useful triage tool in detecting preinvasive and early invasive tumors in HPV DNA-positive postmenopausal women.

查看原文本刊更多论文

宫颈癌筛查中hpv阳性绝经后妇女的细胞学分诊。

背景：在全球范围内，宫颈细胞学仍然是宫颈癌筛查规划的基石，但世卫组织2021年指南主张将HPV DNA检测作为主要筛查方式，因为其敏感性较高。这种方法需要额外的细胞学或阴道镜检查来检测癌前病变。绝经后妇女的激素变化和解剖学改变可能影响两种模式的诊断结果。目的：描述hpv阳性绝经后妇女的细胞学病变谱，以检测癌前病变，作为宫颈癌筛查的一部分。方法：根据The Bethesda System 2014报告高危绝经后hpv阳性妇女的常规细胞学涂片。记录阳性涂片的随访活检结果，并进行细胞组织学相关性分析。结果：回顾性研究包括124名平均年龄为52岁的绝经后女性高危HPV DNA阳性的常规细胞学涂片。在124例病例中，68例HPV 16和/或18阳性，56例其他高危HPV阳性。细胞学上，78%的上皮内病变呈阴性。HSIL+病变占12%，HPV16/18优势涂片中低级别病变占10%。17例涂片的随访活检显示2例SCC， 11例HSIL+， 2例LSIL， 2例阴性/良性病变。在细胞组织学不一致的病例中，4例经复查后升级。结论：细胞学检查是检测绝经后HPV dna阳性妇女侵袭前和早期侵袭性肿瘤的有效鉴别工具。

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

Diagnostic Cytopathology 医学-病理学

CiteScore

2.60

自引率

7.70%

发文量

163

审稿时长

3-6 weeks

期刊介绍： Diagnostic Cytopathology is intended to provide a forum for the exchange of information in the field of cytopathology, with special emphasis on the practical, clinical aspects of the discipline. The editors invite original scientific articles, as well as special review articles, feature articles, and letters to the editor, from laboratory professionals engaged in the practice of cytopathology. Manuscripts are accepted for publication on the basis of scientific merit, practical significance, and suitability for publication in a journal dedicated to this discipline. Original articles can be considered only with the understanding that they have never been published before and that they have not been submitted for simultaneous review to another publication.