Can High Risk Human Papilloma Virus (HR-HPV) Testing Predict the High Grade Cervical Intraepithelial Neoplasia or Higher in Abnormal Liquid-Based Cervical Cytology?
Athita Chanthasenanont MD*, Supapen Lertvutivivat MD*, Teerapat Muangto MD*, Densak Pongrojpaw MD*, Tongta Nanthakomon MD*, Kornkarn Bhamarapravatana PhD**, Komsun Suwannarurk MD*
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand ** Department of Preclinical Science, Faculty of Medicine, Thammasat University Hospital, Pathumthani, Thailand
Objective : To study the prevalence of HR-HPV, high grade cervical intraepithelial neoplasia (CIN2/3) and cancer diagnosis
in women who had liquid-based cervical cytology (LBP) report with low grade and high grade squamous intraepithelial
lesion (LSIL and HSIL) in the women who attended gynecological clinic for cervical cancer screening.
Material and Method: This retrospective study recruited participants who underwent co-testing (LBP with HPV testing)
between July 2013 and June 2016 from medical records. Participants with abnormal Pap smear i.e., LSIL, HSIL, and
malignancy were included. Data collected including age, Pap reports and HPV testing results. Cervical cytology, histopathological
report from colposcopic directed biopsy and HR-HPV testing were analyzed.
Results : A total of 2,144 participants were enrolled. Prevalence of LSIL, HSIL and cancer from LBP were 1.4% (30), 1.07%
(23) and 0.37% (8), respectively. CIN2+ in cases with LSIL and HSIL reports were 7.1% and 8.6%, respectively. There was
no cancer in women who had LBP report of LSIL. In this study, there was no case of CIN2/3 in women with LSIL who had
HR-HPV negative (negative predictive value; NPV 100%). All of women with HSIL reports had HR-HPV testing positive.
Ninety percent of cases with HSIL reports had histopathological reports CIN2/3 and cancer.
Conclusion : In women with LSIL reports and negative HR-HPV testing, there was no silent CIN2/3. In the situation that
colposcopy was not available, HR-HPV testing and LBP can assist the medical person to reduce the colposcopy referral.
Keywords : Cervical intraepithelial neoplasia, Cancer, Colposcopy, Pap, HPV testing
