Aparna Chacko, Vishaka C. Bidkar, Geeta Acharya, Julian Crasta
{"title":"宫颈癌筛查中hpv阳性绝经后妇女的细胞学分诊。","authors":"Aparna Chacko, Vishaka C. Bidkar, Geeta Acharya, Julian Crasta","doi":"10.1002/dc.25456","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>To describe the spectrum of cytological lesions in HPV-positive postmenopausal women to detect precancerous lesions as part of cervical cancer screening.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Cytology is a useful triage tool in detecting preinvasive and early invasive tumors in HPV DNA-positive postmenopausal women.</p>\n </section>\n </div>","PeriodicalId":11349,"journal":{"name":"Diagnostic Cytopathology","volume":"53 5","pages":"246-250"},"PeriodicalIF":1.0000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cytology Triage for HPV-Positive Postmenopausal Women in a Setting of Cervical Cancer Screening\",\"authors\":\"Aparna Chacko, Vishaka C. Bidkar, Geeta Acharya, Julian Crasta\",\"doi\":\"10.1002/dc.25456\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>To describe the spectrum of cytological lesions in HPV-positive postmenopausal women to detect precancerous lesions as part of cervical cancer screening.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Cytology is a useful triage tool in detecting preinvasive and early invasive tumors in HPV DNA-positive postmenopausal women.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11349,\"journal\":{\"name\":\"Diagnostic Cytopathology\",\"volume\":\"53 5\",\"pages\":\"246-250\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2025-02-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diagnostic Cytopathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/dc.25456\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"MEDICAL LABORATORY TECHNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/dc.25456","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
Cytology Triage for HPV-Positive Postmenopausal Women in a Setting of Cervical Cancer Screening
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.
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.
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