Utility of Human Papillomavirus Genotyping for Triage of Patients with Atypical Squamous Cells of Undetermined Significance by Cervical Cytology

摘要

Background/Aim: No human papillomavirus (HPV) type-specific guidelines exist for managing cases of patients with atypical squamous cells of undetermined significance (ASC-US) by cervical cytology. Herein, we investigated ASC-US triage strategies using HPV genotyping to identify methods that are potentially superior to triage, using Hybrid Capture 2. Materials and Methods: In this retrospective cohort study, 144 Korean women with ASC-US cytology underwent HPV genotyping and punch biopsy under colposcopy/endocervical curettage. We created a model for ASC-US triage using HPV genotyping in these patients. The sensitivity of the final triage criterion was internally validated using bootstrapping. Results: Positivity for HPV16, 18, 31, 33, 52 and 58 genotype corresponded to a referral rate of 63% and detection of 92% of cases of cervical intraepithelial neoplasia grade 2 or higher. The referral and detection rates for such cases increased in proportion to the number of high-risk HPV types. The sensitivity of genotyping for HPV16, 18, 31, 33, 52 and 58 was 92%. Conclusion: The study demonstrates that HPV genotyping of specific HR-HPV types may be an effective strategy in ASC-US triage and may replace conventional HPV tests.