Cytological, Histological Correlations and Human Papillomavirus Testing in the Diagnosis of Cervical Intraepithelial Neoplasia

Introduction: Persistent infection with high risk Papillomavirus (HR HPV) is the main risk factor for cervical cancer. Usually there is a period of approximately 10 years since someone gets infected with HPV till the incidence of an invasive cancer. The slow evolution of precancerous lesions allows their detection before the invasive stage. The objective of this study is to evaluate correlations among cytology, colposcopically guided biopsy and HPV testing, HR HPV prevalence and the reliability of cervical-uterine smears as screening method.
Material and method: The study comprises a number of 64 patients who underwent colposcopy, cytodiagnosis and biopsy examinations during January 2010 – December 2011 at Saint Die Hospital (France). Testing for HR HPV was performed especially in case of ASCUS Pap smears.
Results: ASCUS results of cervical-uterine smears corresponded to histological diagnosis of normal aspect and benign lesions in 60% of the cases, in 26.66% of cases with low grade malignant lesions and in 13.33% of the cases with high grade malignant lesions. HR HPV testing was positive especially in patients younger than 30 years (93.33% of patients who performed the HR HPV test), for patients between 30 and 50 years HR HPV was present in 80% of tested patients and for patients over 50 years was present only in 20% of the cases. Neither of the patients who tested negative for HR HPV presented high grade malignant lesions as a result of the biopsy test.
Conclusions: There is a direct correlation between the presence of HPV and grade of malignancy, thus all patients presenting high grade malignant lesions tested positive for HR HPV. HPV testing should not be performed in patients with LSIL results when sampling cervical-uterine smears, because the HPV prevalence is highly increased and a positive HR HPV test result would only create panic in young patients.