Temporal associations of human papillomavirus infection with cervical cytological abnormalities

Article Abstract:

Some human papillomavirus (HPV) infections in the cervix (genital warts) have been associated with cancerous and noncancerous gynecological lesions. The genetic material of replicating the virus, HPV DNA, can be found in cells adjacent to HPV-infected cells and in the cervical cells of women without the disease. It is speculated that cells containing HPV DNA may play a role in the development of cancerous lesions. For the relationship of HPV infection and cervical cancer to be clarified, the role of HPV infections in women having normal laboratory evaluations of cervical cells must be ascertained. A test for HPV infection was performed on 398 women. Pap smears, a sample of cervical cells sent to a laboratory for analysis of cell changes (cytology), were performed on the same day. The cytological results were correlated with those obtained from previous medical records. Of the 289 women with normal results, 10 percent had HPV DNA of any type. Out of 38 women with reactive atypia (cell changes suggestive of metaplastic, glandular or undefined cells), five women (13 percent) had HPV DNA. Of the 33 women with evidence of cervical intraepithelial neoplasia (CIN, cancer limited to the epithelial cell surface), 58 percent had HPV DNA. The results were the same even when adjusted for the use of oral contraceptive and age, two factors known to increase the likelihood of detecting HPV. Women with a medical history of abnormal cells were more likely to have HPV DNA than women without such a history. When these women were examined two years later, three out of 20 women (15 percent) with normal initial Pap smears later developed CIN, compared with nine out of 195 women (five percent) of the women testing negative for HPV DNA. Although the sample population was small, it appears that HPV DNA can be used to reveal past, present and recurrent cervical cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Risk factors, Development and progression, Cervical cancer, Cytodiagnosis, Exfoliative cytology

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Human papillomavirus testing by hybrid capture appears to be useful in triaging women with a cytologic diagnosis of atypical squamous cells of undetermined significance

Article Abstract:

Human papillomavirus virus HPV testing may prove to be a useful method for determining which women should have a colposcopic examination after a Pap smear containing "atypical" cells. Certain strains of HPV are associated strongly with the development of cervical cancer. A group of 217 women attending a college student health service had a Pap smear diagnosis of atypical squamous cells of undetermined significance. All had a colposcopic examination of their genitals and cervix with biopsy where appropriate and a repeat Pap smear. A sample for HPV analysis was taken by rotating a brush within the cervix. The presence of cancer-associated strains of HPV correctly identified 86% of women with abnormal cervical changes and 93% of women with cancer. Including evidence from the repeat Pap smear or lowering the test threshold identified all women with cancer. This suggests that follow-up tests can safely avoid the expense of colposcopy among a substantial proportion of women with an atypical Pap smear.

Testing, DNA

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Qualification of atypical squamous cells of undetermined significance in an independent laboratory: is it useful or significant?

Article Abstract:

Women with the reactive form of atypical squamous cells of undetermined significance can probably be treated conservatively. Atypical cells of undetermined significance are usually found by Pap smear and are cervical cells that are abnormal but not cancerous. Cervical biopsies on 560 women with Pap smears showing atypical squamous cells of undetermined significance revealed that 36% had a precancerous condition called squamous intraepithelial lesions. Ninety-four had high-grade squamous intraepithelial lesions.

Diagnosis, Cervix dysplasia

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