Human papillomavirus testing in patients with cytological diagnosis of atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions

Abstract

Aim of the Study: To determine whether human papillomavirus (HPV) testing is useful in the evaluation of patients diagnosed with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LGSIL). Patients and Methods: The results of 46 patients with ASCUS/LGSL diagnoses of Papanicolaou smears were reviewed taking into consideration the results of HPV polymerase chain reaction (PCR) tests and histological findings.40 of them were with LGSL and 6 with ASCUS cytological diagnosis. Results: 25 (54,3) of the patients were positive for HPV DNA and of them 16 (34,8) with high-risk HPV types, 6 (13,0) with low-risk types and 3 (6.5) with uncharacterized types of HPV. Biopsies and/or endocervical curettage of the cervix confirmed that 6 of the patients had a higher-grade lesion - CIN2/CIN3. Five of them (three LGSIL-s and two ASCUS-es) were with high-risk types of HPV and 1 patient (cytological smear - LGSIL) was HPV negative. That means that 5 (of 16) or 31,2 of the patients with high-risk types (in four patients HPV type 16 and in one HPV type 31) and only one from the HPV negative patients were diagnosed a higher grade of SIL. Conclusion: Although PCR HPV testing is expensive as a screening tool it is very useful in selection and proper histologic diagnosis of high-grade squamous intraepithelial lesions.