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European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Original Research
Cervical atypical glandular cells and false negative HPV testing: a dramatic reality of the wrong test at the right place
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1
Department of Gynecology and Gynecologic Oncology, Antwerp University Hospital, University of Antwerp, Antwerp
2
Department of Molecular Pathology (RIATOL), Sonic Healthcare Benelux, Antwerp (Belgium)
Eur. J. Gynaecol. Oncol. 2014, 35(2), 117–120;
https://doi.org/10.12892/ejgo24042014
Published: 10 April 2014
Abstract
Background: Due to cervical cancer screening the number of squamous cancer have declined. The number of adenocarcinomas (ADCs) does appear to be rising. ADCs are often missed and human papillomavirus (HPV) testing could be helpful in detecting these abnormalities earlier. Case: A 36-year-old woman, who had a normal smear three years earlier, had a pap smear with atypical glandular cells. The L1 HPV test showed that there was no HPV infection. Other HPV tests which looked at E6 and E7 showed an infection with HPV 16. Due to unknown reasons, no action was taken regarding the atypical glandular cells. Two years later the patient was diagnosed with a FIGO Stage IVb ADC of the cervix. The L1 HPV test was still negative and the E6/E7 HPV test was still positive. Despite several multiple treatment modalities she succumbed of her disease two years later leaving behind a young family. Conclusion: HPV test looking only at L1 can give false negative results if the virus is integrated in the human genome.
Keywords
Human papillomavirus
HPV
Adenocarcinoma
L1
E6
E7
Integration
False negative
Cervical cancer
Prophylactic vaccination
Screening
Cross-protection
HPV testing