The triage of ASC-US/LSIL cytology by HPV DNA testing and genotyping in Northern Thailand

Abstract

Objective To assess the benefit of high-risk human papillomavirus (hrHPV) DNA testing and genotyping in the histologic detection of high-grade squamous intraepithelial lesion or worse (HSIL+) in women with low-grade abnormal cytologies [atypical squamous cells of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL)]. Methods A prospective study on samples from women with ASC-US/LSIL cytology who were referred for colposcopy between October 2010 and October 2012. Hybrid capture 2 (HC2) was used for hrHPV DNA testing. HPV genotyping was performed by the linear array assay. Cervical tissue histology was obtained by biopsy or LEEP in all patients. Results Of 101 women with ASC-US/LSIL cytology, 45 (44.6%) were HC2-positive and 56 (55.4%) were HC2-negative. Compared with the HC2-negative group, the HC2-positive group had significantly higher rates of histologic HSIL+ (24.4% vs 0%, p p = 0.026). HC2-positive patients with either of 4 HPV genotypes (16/18/52/58) had a significantly higher rate of histologic HSIL+ than those without (40.7% vs 0%, p = 0.003). Conclusions In northern Thailand, hrHPV DNA testing is useful in the triage of women with ASC-US/LSIL cytology. Genotyping for HPV16/18/52/58 has an additional value in the selection of the women who require immediate colposcopy.