The use of reflex high-risk human papillomavirus testing for atypical squamous cells of undetermined significance interpretations on vaginal specimens

✍ Scribed by Brian S. Kendall; Christopher M. Zahn

• Publisher: Wiley (John Wiley & Sons)
• Year: 2009
• Tongue: English
• Weight: 109 KB
• Volume: 117
• Category: Article
• ISSN: 1934-662X
• DOI: 10.1002/cncy.20012

✦ Synopsis

Abstract

BACKGROUND:

The use of reflex high‐risk human papillomavirus (hrHPV) testing as a triage method for cervical specimens with an interpretation of atypical squamous cells of undetermined significance (ASC‐US) is well established. To the authors' knowledge, very little has been reported regarding the utility of this approach in vaginal specimens in women with a prior hysterectomy. The current study evaluated the results of hrHPV testing in women with vaginal specimens interpreted as ASC‐US in the authors' laboratory.

METHODS:

Follow‐up information, including results of hrHPV testing, was sought for all vaginal smears reported as ASC‐US from the authors' cytology laboratory during the calendar years 2005 and 2006.

RESULTS:

For the 2 years reviewed, 254 ASC‐US vaginal specimens were available for assessment. Reflex hrHPV testing was requested on 236 (92.9%), with sufficient residual material available in 193 specimens. hrHPV was detected in 44 (22.8%). Follow‐up results were available for 136 specimens, with a squamous intraepithelial lesion (SIL, all but 1 of which was low grade) found to be present in 21 (15.4%). SIL was identified in significantly more women in whom hrHPV was detected compared with those in whom hrHPV was not detected (41.9% vs 4.2%; P < .001 by the Fisher exact test).

CONCLUSIONS:

Rates of detection of squamous abnormalities in women with ASC‐US on vaginal preparations in whom hrHPV was detected were found to be higher than in those without hrHPV. These findings suggest that clinical follow‐up is needed for women in whom hrHPV is detected. hrHPV testing may be clinically useful as a method of triage for women with ASC‐US vaginal smears. Cancer (Cancer Cytopathol) 2009. Published 2009 by the American Cancer Society.