Efficacy of reflex HPV16/18 genotyping in predicting CIN3/VAIN3 in women with HPV+/Pap– results

Ming Guo, Abha Khanna, Marilyn Dawlett, Shobha Patel, Yun Gong, Gregg Staerkel

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Introduction Genotyping for human papillomavirus (HPV) types 16/18 has been recommended for women with HPV+/Pap− co-testing results on cervical cancer screening. In this study, we evaluated the efficacy of reflex HPV16/18 genotyping for predicting high-grade cervical and vaginal intraepithelial neoplasia (CIN3/VAIN3) in women who underwent a HPV16/18 genotyping test following HPV+/Pap− co-testing results. Materials and methods We retrospectively reviewed records of 175 women who underwent reflex HPV16/18 genotyping after HPV+/Pap− co-testing results at our institution from 2011 to 2013. The HPV16/18 genotyping results using the Cervista HPV16/18 assay were correlated with follow-up data (ie, 107 biopsy and 68 Pap test) to assess the risk of CIN3/VAIN3. Results In 175 women (median age: 51 years), HPV16 and/or 18 were detected in 47 women (26.9%): 36 with HPV16, 9 with HPV18, and 2 with HPV16 and 18. The cumulative incidence of CIN3/VAIN3 was 4.6-fold higher in women with a positive HPV16/18 genotyping result (10.6%) than in women with a negative HPV16/18 result (2.3%) with a statistically significant difference (P = 0.015). The predictive value of reflex HPV16/18 genotyping for CIN3/VAIN3 was 63% (5 out of 8). Conclusions A positive reflex HPV16/18 genotyping result predicts a significantly higher risk of CIN3/VAIN3 than a negative reflex 16/18 HPV result, supporting the need for an immediate colposcopy evaluation in these patients. For women with a negative reflex HPV16/18 genotyping result, an annual HPV/Pap cytology co-testing is a reasonable follow-up to predict non-16/18 HPV–associated CIN3/VAIN3.

Original languageEnglish (US)
Pages (from-to)31-36
Number of pages6
JournalJournal of the American Society of Cytopathology
Volume5
Issue number1
DOIs
StatePublished - Jan 1 2016

Keywords

  • Follow-up biopsy
  • HPV+/Pap– co-testing result
  • HPV16/18 genotyping
  • Human papillomavirus
  • Pap cytology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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