Stratified risk of high-grade cervical disease using onclarity HPV extended genotyping in women, ≥25 years of age, with NILM cytology
| Autor: | Charles K. Cooper, Thomas C. Wright, Jeffrey C Andrews, Karen Yanson, Valentin Parvu, Mark H. Stoler |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Risk 0301 basic medicine medicine.medical_specialty Genotype Population Uterine Cervical Neoplasms Cervix Uteri Disease Cervical intraepithelial neoplasia 03 medical and health sciences 0302 clinical medicine Cytology Biopsy Prevalence medicine Humans Human papillomavirus 31 Longitudinal Studies education Papillomaviridae Genotyping Colposcopy Human papillomavirus 16 education.field_of_study medicine.diagnostic_test Obstetrics business.industry Papillomavirus Infections Obstetrics and Gynecology Uterine Cervical Dysplasia medicine.disease female genital diseases and pregnancy complications 030104 developmental biology Oncology 030220 oncology & carcinogenesis Female Neoplasm Grading business |
| Zdroj: | Gynecologic Oncology. 153:26-33 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2018.12.024 |
| Popis: | Objectives Increasing evidence suggests that extended human papillomavirus (HPV) genotyping (beyond 16/18) is effective for risk stratification in women with normal cytology. This report provides extended genotyping results, using the BD Onclarity HPV Assay, for individual genotypes HPV16, 18, 31, 45, 51, and 52 and three pooled genotype results for HPV33/58, 35/39/68, and 56/59/66. Methods 27,037 women with normal cytology, ≥25 years, were enrolled into the Onclarity HPV trial during routine screening. Women positive for any HPV genotype were referred to colposcopy/biopsy. Hierarchical-ranked prevalence and risk values, associated with cervical intraepithelial neoplasia, grade 2 or worse (≥CIN2) or ≥CIN3, were calculated based on extended genotyping results. Results HPV 16 and 31 carried the highest risk for ≥CIN2 (11.6% and 12.1%, respectively) and ≥CIN3 (8.1% and 7.5%, respectively); these genotypes were the most prevalent in both ≥CIN2 (29.6% and 19.3%, respectively) and ≥CIN3 (43.7% and 22.5%, respectively). Of the other 12 genotypes, HPV 18, 33/58, and 52 comprised an intermediate risk band (≥CIN2 risk range: 4.9–6.8%; ≥CIN3 risk range: 3.9–5.0%). Genotypes 45, 51, 35/39/68, and 56/59/66 constituted the lowest risk band for both disease grades (≥CIN2 value risk range: 1.7–3.0%; ≥CIN3 value risk range: 1.2–3.6%). Conclusions Extended genotyping stratifies risk for ≥CIN2/3 in the ≥25 year-old, normal cytology population. While baseline HPV 16/31 values exceeded the risk threshold for colposcopy referral, the management of women with normal cytology who were positive for the intermediate- or lower-risk genotypes may evolve based on refined risk estimates as well as clinical factors. |
| Databáze: | OpenAIRE |
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