Comparison of cytopathologic findings in patients with negative Pap test and positive high-risk HPV infection among three groups

Arch Gynecol Obstet. 2022 Sep;306(3):857-863. doi: 10.1007/s00404-022-06444-0. Epub 2022 Mar 1.

Abstract

Purpose: Comparison of colposcopy-guided biopsy and endocervical cytologic (ECC) results in patients with negative Papanicolaou (Pap) and positive high-risk (HR) HPV tests in the three groups of HPV 16/18, non-16/18 HR-HPV (other HR-HPV), and concurrent infection of either HPV 16/18 and at least one subtype of other HR-HPVs.

Methods: This cross-sectional study was conducted among women aged 30-65 who had negative Pap and positive HR-HPV DNA tests. Pap test was performed using liquid cytology. For HPV DNA testing, the polymerase chain reaction (PCR) method was used.

Results: Among 394 participants, 111 (28.2%) were in the HPV 16/18, 226 (57.4%) in the Other HR-HPV, and 57 (14.4%) in the concurrent group. The mean age of participants was 35.71 ± 7.1 years. Cervical intraepithelial neoplasia (CIN) grade 2/3 were seen in 29 (26.1%) patients of HPV 16/18, 60 (26.5%) of other HR-HPV, and 18 (31.6%) of concurrent infection group (P = 0.593). HPV 52 was the most common subtype in the other HR-HPV group (15%).

Conclusions: The risk of high-grade CIN lesions in patients with negative Pap test and positive other HR-HPV was not significantly less than patients with positive HPV 16/18. Besides, the risk of losing the patients to 1-year follow-up seems high.

Keywords: Cervical intraepithelial neoplasia; Colposcopy; Papanicolaou test; Papillomavirus infections.

MeSH terms

  • Adult
  • Colposcopy
  • Cross-Sectional Studies
  • DNA, Viral / analysis
  • Female
  • Human papillomavirus 16 / genetics
  • Human papillomavirus 18 / genetics
  • Humans
  • Papanicolaou Test
  • Papillomaviridae / genetics
  • Papillomavirus Infections* / complications
  • Papillomavirus Infections* / diagnosis
  • Papillomavirus Infections* / pathology
  • Pregnancy
  • Uterine Cervical Dysplasia* / pathology
  • Uterine Cervical Neoplasms* / pathology
  • Vaginal Smears / methods

Substances

  • DNA, Viral