Comparison of cytopathologic findings in patients with negative Pap test and positive high-risk HPV infection among three groups

• Published in: Archives of gynecology and obstetrics 2022-09, Vol.306 (3), p.857-863
• Main Authors: Kasraei, Sara, Ghahghaei-nezamabadi, Akram, Seifollahi, Akram, Aghajani, Faezeh, Nakhostin-Ansari, Amin, Zarei, Neda, Tehranian, Afsaneh
• Format: Article
• Language: English
• Subjects: Endocrinology; Gynecologic Oncology; Gynecology; Human Genetics; Human papillomavirus; Infections; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Pap smear
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-022-06444-0

Purpose Comparison of colposcopy-guided biopsy and endocervical cytologic (ECC) results in patients with negative Papanicolaou (Pap) and positive high-risk (HR) HPV tests in the three groups of HPV 16/18, non-16/18 HR-HPV (other HR-HPV), and concurrent infection of either HPV 16/18 and at least one subtype of other HR-HPVs. Methods This cross-sectional study was conducted among women aged 30–65 who had negative Pap and positive HR-HPV DNA tests. Pap test was performed using liquid cytology. For HPV DNA testing, the polymerase chain reaction (PCR) method was used. Results Among 394 participants, 111 (28.2%) were in the HPV 16/18, 226 (57.4%) in the Other HR-HPV, and 57 (14.4%) in the concurrent group. The mean age of participants was 35.71 ± 7.1 years. Cervical intraepithelial neoplasia (CIN) grade 2/3 were seen in 29 (26.1%) patients of HPV 16/18, 60 (26.5%) of other HR-HPV, and 18 (31.6%) of concurrent infection group ( P  = 0.593). HPV 52 was the most common subtype in the other HR-HPV group (15%). Conclusions The risk of high-grade CIN lesions in patients with negative Pap test and positive other HR-HPV was not significantly less than patients with positive HPV 16/18. Besides, the risk of losing the patients to 1-year follow-up seems high.