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The clinical relevance of human papillomavirus negative status in unsatisfactory cervical cytology

  • General Gynecology
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Abstract

Purpose

The aim of this study was to evaluate the clinical relevance of high-risk human papillomavirus (HR-HPV) negativity at the time of unsatisfactory cervical cytology.

Methods

In this retrospective observational study, records were reviewed for patients who had unsatisfactory cervical cytology with HR-HPV testing performed from January 2015 through September 2019 at a large teaching hospital. Pathology results of follow-up cervical cytology and biopsies were assessed.

Results

Of 1282 patients with unsatisfactory cervical cytology and negative HR-HPV testing, repeat cytology was negative for intraepithelial lesion (NIL) in 952 (75%) patients, unsatisfactory in 273 (22%) patients, and abnormal in 41 (3%) patients. Median follow-up time was 91 days. The concordance of HR-HPV status between initial unsatisfactory cervical cytology and subsequent satisfactory cervical cytology was 96.3% for HR-HPV negative patients and 68.8% for HR-HPV positive patients. Compared to women who were HR-HPV negative, women who were HR-HPV positive on initial unsatisfactory cytology were at higher risk of subsequent cervical intraepithelial neoplasia (CIN) 2 or greater (odds ratio = 4.91, 95% confidence interval: 1.34–18.03 for E6/E7 mRNA positivity alone; odds ratio = 46.13, 95% confidence interval: 13.45–158.01 for HR-HPV genotype 16 or 18/45 positivity).

Conclusion

In the 3 month follow-up of patients with unsatisfactory cervical cytology and negative HR-HPV testing, approximately 3% had abnormal cytology but no cases of HPV related pathology of CIN 2 or greater were found. There was high concordance of negative HR-HPV testing results with those on follow-up satisfactory cervical cytology.

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Data availability

Completely deidentified data are available upon reasonable request and approval by University of Southern California Institutional Review Board and obtained Data Use Agreement between the institutions.

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Funding

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA

    Syem K. Barakzai & Brian J. Gordon

  2. Department of Internal Medicine, University of Southern California, Los Angeles, CA, USA

    Ailene Nguyen

  3. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Sanchala Sehgal

  4. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA

    Koji Matsuo

  5. Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA

    Koji Matsuo

  6. Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Wenjing Shi

  7. Department of Pathology, University of California Irvine, Orange, CA, USA

    Sonia Veran-Taguibao

  8. Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Melissa L. Wilson

Authors
  1. Syem K. Barakzai
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  2. Ailene Nguyen
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  3. Sanchala Sehgal
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  4. Koji Matsuo
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  5. Wenjing Shi
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  6. Sonia Veran-Taguibao
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  7. Melissa L. Wilson
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  8. Brian J. Gordon
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Contributions

Conceptualization: SKB, BJG; Data curation: SKB, AN, SS, WS, SV, and BJG; Formal analysis: SKB, MLW, BJG; Funding acquisition: n/a; Investigation: all authors; Methodology: SKB, BJG, KM; Project administration: SKB, BJG; Resources: SKB, BJG; Software: SKB, BJG.; Supervision: KM, BJG; Validation: SKB, BJG; Visualization: SKB, BJG; Writing—original draft: SKB, BJG; Writing -review & editing: all authors.

Corresponding author

Correspondence to Syem K. Barakzai.

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Ethical approval

University of Southern California Institutional Review Board (HS-19-00775).

Transparency

The manuscript’s corresponding author (S.K.B.) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

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Barakzai, S.K., Nguyen, A., Sehgal, S. et al. The clinical relevance of human papillomavirus negative status in unsatisfactory cervical cytology. Arch Gynecol Obstet 307, 1021–1025 (2023). https://doi.org/10.1007/s00404-022-06870-0

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  • DOI: https://doi.org/10.1007/s00404-022-06870-0

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