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HPV status in women with high-grade dysplasia on cervical biopsy and preceding negative HPV tests.

Authors
  • Ge, Yimin1
  • Mody, Roxanne R2
  • Olsen, Randall J3
  • Zhou, Haijun4
  • Luna, Eric5
  • Armylagos, Donna5
  • Puntachart, Natu4
  • Hendrickson, Heather4
  • Schwartz, Mary R4
  • Mody, Dina R3
  • 1 Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Weill Medical College of Cornell University, New York, New York. Electronic address: [email protected]
  • 2 Department of Obstetrics and Gynecology, St. Joseph's Hospital, Denver, Colorado.
  • 3 Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas; Weill Medical College of Cornell University, New York, New York.
  • 4 Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas.
  • 5 BioReference Laboratories, Houston, Texas.
Type
Published Article
Journal
Journal of the American Society of Cytopathology
Publication Date
Jan 01, 2019
Volume
8
Issue
3
Pages
149–156
Identifiers
DOI: 10.1016/j.jasc.2019.01.001
PMID: 31097291
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

A considerable number of patients with high-grade cervical lesions have undergone preceding human papillomavirus (HPV) tests with negative results. In the present study, we attempted to elucidate the factors potentially contributing to the findings by testing biopsied samples from these patients. Of the 1654 women with HPV testing and follow-up cervicovaginal biopsies from March 1, 2013 to June 30, 2014, 21 of 252 women (8.3%) with biopsy-confirmed high-grade squamous intraepithelial lesion (HSIL) or worse had had negative results from preceding high-risk (hr)HPV tests. The corresponding paraffin blocks were tested for HPV using the Cobas 4800 system, a DNA microarray against 40 HPV genotypes, and DNA sequencing. HPV was detected in 20 (95%) of the 21 biopsies with HSIL or worse, including HPV16/18 in 4, non-16/18 hrHPV in 10, and non-hrHPV in 6. HPV59 and HPV45 were 2.2 times more frequently detected than HPV16/18 in these samples. One sample was negative for all 3 tests (5%). Our study has demonstrated that 8.3% of women with biopsy-confirmed HSIL or worse had preceding test results that were negative for hrHPV. The vast majority of the biopsied samples had detectable HPV, primarily hrHPV genotypes (67%) with HPV59 and HPV45 predominance. This genotypic prevalence pattern was markedly different from those reported in the general population. Non-hrHPV genotypes contributed to 29% of the cases, and HPV-negative cases were rare. In addition to the limited Cobas testing panel and rare possible HPV-negative HSIL or worse, other possible contributing factors to the discrepancy include cytologic sampling, interference material, technical errors, and reduced L1 gene expression in high-grade lesions. Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

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