Predicting Factors for High-Grade Cervical Dysplasia in Women With Low-Grade Cervical Cytology and Nonvisible Squamocolumnar Junction

Giorgio Bogani, Francesca Taverna, Claudia Lombardo, Antonino Ditto, Fabio Martinelli, Mauro Signorelli, Valentina Chiappa, Umberto Leone Roberti Maggiore, Lavinia Mosca, Ilaria Sabatucci, Cono Scaffa, Domenica Lorusso, Francesco Raspagliesi

Research output: Contribution to journalArticle

Abstract

Objective: To assess the risk of developing high-grade cervical dysplasia among women with low-grade cervical cytology and nonvisible squamocolumnar junction (SCJ) at colposcopic examination. Methods: Data of consecutive women with low-grade intraepithelial lesion(≤LSIL) undergoing colposcopic examination, which was unsatisfactory (due to the lack of the visualization of the entire SCJ), were retrospectively reviewed. The risk of developing high-grade cervical intraepithelial neoplasia (CIN2+) was assessed using Kaplan-Meier and Cox models. Results: Data of 86 women were retrieved. Mean (standard deviation [SD]) age was 36.3 (13.4) years. A total of 71 (82.5%) patients had high-risk human papillomavirus (HR-HPV) at the time of diagnosis. Among the 63 patients undergoing repetition of HPV testing, 15 (24%) and 48 (76%) women had positive and negative tests for HR-HPV at 12 months, respectively. We observed that 5 (33%) of 15 patients with HPV persistence developed CIN2+, while only 1 (2%) patient of 48 patients without HPV persistence developed CIN2+ (odds ratio [OR]: 23.5; 95% confidence interval [CI]: 2.46-223.7; P <.001). The length of HR-HPV persistence correlated with an increased risk of developing CIN2+ (P <.001; P for trend). High-risk HPV persistence is the only factor predicting for CIN2+ (hazard ratio: 3.19; 95% CI: 1.55-6.57; P =.002). Conclusions: High-risk HPV persistence predicts the risk of developing CIN2+ in patients with unsatisfactory colposcopic examination. Further studies are warranted in order to implement the use of HPV testing in patients with unsatisfactory colposcopy.

Original languageEnglish
Pages (from-to)44-48
Number of pages5
JournalReproductive Sciences
Volume26
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

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Uterine Cervical Dysplasia
Cell Biology
Confidence Intervals
Colposcopy
Cervical Intraepithelial Neoplasia
Proportional Hazards Models
Odds Ratio

Keywords

  • CIN
  • high-grade dysplasia
  • HPV
  • unsatisfactory colposcopy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Predicting Factors for High-Grade Cervical Dysplasia in Women With Low-Grade Cervical Cytology and Nonvisible Squamocolumnar Junction. / Bogani, Giorgio; Taverna, Francesca; Lombardo, Claudia; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Maggiore, Umberto Leone Roberti; Mosca, Lavinia; Sabatucci, Ilaria; Scaffa, Cono; Lorusso, Domenica; Raspagliesi, Francesco.

In: Reproductive Sciences, Vol. 26, No. 1, 01.01.2019, p. 44-48.

Research output: Contribution to journalArticle

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abstract = "Objective: To assess the risk of developing high-grade cervical dysplasia among women with low-grade cervical cytology and nonvisible squamocolumnar junction (SCJ) at colposcopic examination. Methods: Data of consecutive women with low-grade intraepithelial lesion(≤LSIL) undergoing colposcopic examination, which was unsatisfactory (due to the lack of the visualization of the entire SCJ), were retrospectively reviewed. The risk of developing high-grade cervical intraepithelial neoplasia (CIN2+) was assessed using Kaplan-Meier and Cox models. Results: Data of 86 women were retrieved. Mean (standard deviation [SD]) age was 36.3 (13.4) years. A total of 71 (82.5{\%}) patients had high-risk human papillomavirus (HR-HPV) at the time of diagnosis. Among the 63 patients undergoing repetition of HPV testing, 15 (24{\%}) and 48 (76{\%}) women had positive and negative tests for HR-HPV at 12 months, respectively. We observed that 5 (33{\%}) of 15 patients with HPV persistence developed CIN2+, while only 1 (2{\%}) patient of 48 patients without HPV persistence developed CIN2+ (odds ratio [OR]: 23.5; 95{\%} confidence interval [CI]: 2.46-223.7; P <.001). The length of HR-HPV persistence correlated with an increased risk of developing CIN2+ (P <.001; P for trend). High-risk HPV persistence is the only factor predicting for CIN2+ (hazard ratio: 3.19; 95{\%} CI: 1.55-6.57; P =.002). Conclusions: High-risk HPV persistence predicts the risk of developing CIN2+ in patients with unsatisfactory colposcopic examination. Further studies are warranted in order to implement the use of HPV testing in patients with unsatisfactory colposcopy.",
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AU - Bogani, Giorgio

AU - Taverna, Francesca

AU - Lombardo, Claudia

AU - Ditto, Antonino

AU - Martinelli, Fabio

AU - Signorelli, Mauro

AU - Chiappa, Valentina

AU - Maggiore, Umberto Leone Roberti

AU - Mosca, Lavinia

AU - Sabatucci, Ilaria

AU - Scaffa, Cono

AU - Lorusso, Domenica

AU - Raspagliesi, Francesco

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AB - Objective: To assess the risk of developing high-grade cervical dysplasia among women with low-grade cervical cytology and nonvisible squamocolumnar junction (SCJ) at colposcopic examination. Methods: Data of consecutive women with low-grade intraepithelial lesion(≤LSIL) undergoing colposcopic examination, which was unsatisfactory (due to the lack of the visualization of the entire SCJ), were retrospectively reviewed. The risk of developing high-grade cervical intraepithelial neoplasia (CIN2+) was assessed using Kaplan-Meier and Cox models. Results: Data of 86 women were retrieved. Mean (standard deviation [SD]) age was 36.3 (13.4) years. A total of 71 (82.5%) patients had high-risk human papillomavirus (HR-HPV) at the time of diagnosis. Among the 63 patients undergoing repetition of HPV testing, 15 (24%) and 48 (76%) women had positive and negative tests for HR-HPV at 12 months, respectively. We observed that 5 (33%) of 15 patients with HPV persistence developed CIN2+, while only 1 (2%) patient of 48 patients without HPV persistence developed CIN2+ (odds ratio [OR]: 23.5; 95% confidence interval [CI]: 2.46-223.7; P <.001). The length of HR-HPV persistence correlated with an increased risk of developing CIN2+ (P <.001; P for trend). High-risk HPV persistence is the only factor predicting for CIN2+ (hazard ratio: 3.19; 95% CI: 1.55-6.57; P =.002). Conclusions: High-risk HPV persistence predicts the risk of developing CIN2+ in patients with unsatisfactory colposcopic examination. Further studies are warranted in order to implement the use of HPV testing in patients with unsatisfactory colposcopy.

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