TY - JOUR
T1 - Detection and outcome of endocervical atypia in cytology in primary HPV screening programme
AU - Pulkkinen, Johanna
AU - Kares, Saara
AU - Huhtala, Heini
AU - Kholová, Ivana
N1 - Funding Information:
Funding: The work was supported by grant from the Competitive Research Funding of the Pirkan-maa Hospital District to Ivana Kholová, grant number VTR X5211. The funding source had no role in the preparation of data or the manuscript.
Funding Information:
The work was supported by grant from the Competitive Research Funding of the Pirkanmaa Hospital District to Ivana Kholova, grant number VTR X5211. The funding source had no role in the preparation of data or the manuscript.
PY - 2021/12
Y1 - 2021/12
N2 - Most endocervical adenocarcinomas (EAC) are associated with high-risk HPV (hrHPV) infection, with HPV genotypes 16, 18 and 45 accounting for >90% of the cases. Among endocervical glandular lesions, screening with hrHPV test has previously shown to predict the outcome better than cytology, although around one-fifth of the EAC remain negative both in hrHPV testing and cytology. The study consists of two consecutive HPV-primary screening rounds, conducted in 2012–2015 and 2017–2020. Of the 87 women aged 35 to 60 years of age diagnosed with Atypical endocervical cells, NOS or Atypical endocervical cells, favor neoplastic cytology during the first screening round, 63 (72.4%) were hrHPV positive and 24 (27.6%) were hrHPV negative. Among hrHPV positive patients, three EAC, two adenocarcinomas in situ (AIS), one AIS + high-grade intraepithelial lesion (HSIL) and 13 HSIL were found. Of the histologically verified lesions, 68.4% (13/19) were purely of squamous origin. All the EAC and AIS were HPV16 or HPV 18 positive. No high-grade histological lesions were found among the hrHPV negative patients with cytological glandular atypia. A later database search revealed one HPV-negative, gastric-type mucinous EAC that was missed by the HPV primary screening.
AB - Most endocervical adenocarcinomas (EAC) are associated with high-risk HPV (hrHPV) infection, with HPV genotypes 16, 18 and 45 accounting for >90% of the cases. Among endocervical glandular lesions, screening with hrHPV test has previously shown to predict the outcome better than cytology, although around one-fifth of the EAC remain negative both in hrHPV testing and cytology. The study consists of two consecutive HPV-primary screening rounds, conducted in 2012–2015 and 2017–2020. Of the 87 women aged 35 to 60 years of age diagnosed with Atypical endocervical cells, NOS or Atypical endocervical cells, favor neoplastic cytology during the first screening round, 63 (72.4%) were hrHPV positive and 24 (27.6%) were hrHPV negative. Among hrHPV positive patients, three EAC, two adenocarcinomas in situ (AIS), one AIS + high-grade intraepithelial lesion (HSIL) and 13 HSIL were found. Of the histologically verified lesions, 68.4% (13/19) were purely of squamous origin. All the EAC and AIS were HPV16 or HPV 18 positive. No high-grade histological lesions were found among the hrHPV negative patients with cytological glandular atypia. A later database search revealed one HPV-negative, gastric-type mucinous EAC that was missed by the HPV primary screening.
KW - Adenocarcinoma in situ
KW - Atypical endocervical cells
KW - Cytology
KW - Endocervical adenocarcinoma
KW - HPV
KW - Screening
U2 - 10.3390/diagnostics11122402
DO - 10.3390/diagnostics11122402
M3 - Article
AN - SCOPUS:85121586692
SN - 2075-4418
VL - 11
JO - Diagnostics
JF - Diagnostics
IS - 12
M1 - 2402
ER -