IMR Press / EJGO / Volume 26 / Issue 4 / pii/2005189

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.

Open Access Original Research

Can viral load, semi-quantitatively evaluated, of human papillomavirus predict cytological or histological outcome in women with atypical squamous or glandular cells of undetermined significance cytology?

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1 Department of Obstetrics and Gynaecology, Medical Center Haaglanden, the Hague, the Netherlands
2 Medical Statistics, Leiden University Medical Center, the Netherlands
3 Department of Pathology, Medical Center Haaglanden, the Hague, and the Department of Gynecology, Leiden University Medical Center, the Netherlands
4 Department of Gynecology, Leiden University Medical Center, the Netherlands
Eur. J. Gynaecol. Oncol. 2005, 26(4), 393–397;
Published: 10 August 2005
Abstract

Objective: 1) To assess the regression to normal cytology in women with cervical smears diagnosed as atypical squamous or glan­dular cells of undetermined significance (ASCUS/ AGUS) and absence or clearance of human papillomavirus (HPV) infection; 2) To evaluate the association between viral load, semi-quantitatively evaluated, and cytological or histological outcome. Material and methods: In this cohort study HPV test and biopsy was taken in 148 women with ASCUS/AGUS cytology. After 12-18 months a HPV test and cervical smear were repeated in 121 women. Results: Absence or clearance of HPV showed significantly more regression to normal cytology than persistent or newly acquired infected women, odds ratio 27 (95% confidence interval; 7-103). The viral load of the HPV test at enrollment was not correlated with the follow-up cytological outcome (Spearman correlation coefficient 0.2, p = 0.2). A marked association between viral load and histological outcome at enrollment was shown (Spearman correlation coefficient 0.43, p < 0.0001). Conclusion: Absence or clearance of HPV can predict regression to normal cytology. Viral load at enrollment cannot predict cyto­logical regression. There was a marked association between viral load and the underlying CIN at enrollment. However, there was large overlapping of viral loads among the grades of CIN. Therefore, viral load is not a useful parameter to predict high-grade lesions in women with ASCUS/ AGUS cytology.

Keywords
Atypical squamous cells of undetermined significance
Atypical glandular cells of undetermined significance
Human papillomavirus
Viral load
Cervical intraepithelial neoplasia
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