High risk HPV testing in the triage of repeat ASC-US and LSIL.
INTRODUCTION
The purpose of this study was to evaluate the real-life performance of high-risk (HR) HPV testing in the triage of repeat atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesions (LSIL).


MATERIAL AND METHODS
In 2004-2012, 127 women with repeat ASC-US and 118 women with LSIL were triaged with HPV testing using either a Hybrid Capture 2(®) or Abbott RealTime(®) HR-HPV test. The patient charts were retrospectively reviewed for performance of the tests.


RESULTS
In the repeat ASC-US group, 40.9% of the women were positive for HR-HPV. The prevalence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was 8.7%. The sensitivity of the HR-HPV testing for detection of CIN2+ was 90.9% (95% Cl 58.7-98.5%), with a specificity of 63.8% (95%CI 54.4-72.5%). In women ≥30 years old, the specificity was 70.4%, whereas in younger women it was only 27.8%. The negative predictive value to predict CIN3 was 100% (95% CI 95.2-100.0%). Of the women with LSIL, 68.6% were positive for HR-HPV and the prevalence of CIN2+ was 14.4%. The sensitivity of HR-HPV testing for detection of CIN2+ was 94.1% (95% CI 71.2-99.0%), and the specificity 35.6% (95% CI 26.4-45.8%), respectively. The negative predictive value to predict CIN3 was 100% (95% CI 90.4-100.0%).


CONCLUSION
HR-HPV testing seems to be beneficial in the triage of repeat ASC-US in women ≥30 years old, but a high prevalence of HR-HPV infection combined with poor specificity limit the use of HPV testing in the case of LSIL.
['Veijalainen|Olga|O|', 'Tuomisaari|Sanna|S|', 'Luukkaala|Tiina|T|', 'Mäenpää|Johanna|J|']
D000293:Adolescent D000328:Adult D065309:Atypical Squamous Cells of the Cervix D018290:Cervical Intraepithelial Neoplasia D005260:Female D061809:Human Papillomavirus DNA Tests D006801:Humans D008875:Middle Aged D030361:Papillomavirus Infections D011237:Predictive Value of Tests D015995:Prevalence D012189:Retrospective Studies D065310:Squamous Intraepithelial Lesions of the Cervix D014218:Triage D002583:Uterine Cervical Neoplasms D014626:Vaginal Smears D055815:Young Adult
ASC-US LSIL squamous intraepithelial lesions CIN HP triage cervical cancer cytology human papillomavirus