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The use of biomarkers and HPV genotyping to improve diagnostic accuracy in women with a transformation zone type 3.


ABSTRACT:

Background

Twenty percent of women referred to colposcopy have a type 3 transformation zone-where colposcopic assessment for high-grade dysplasia (CIN2+) is not possible. This study examines the effectiveness of HPV biomarkers and genotyping in combination with techniques that sample an endocervical TZ.

Methods

A prospective diagnostic accuracy study. Women booked for large-loop excision (LLETZ) with squamous dyskaryosis, high-risk HPV and a TZ3 were recruited. Immediately prior to LLETZ samples were collected for p16/Ki-67 dual-stained cytology, HPV genotyping and H&E, p16- and Ki-67-stained endocervical curettings.

Results

In women with low-grade screening (n = 64), 35.9% had CIN2+; dual-stained cytology had the greatest effect on the PPV of routine screening (76.1% vs 35.9%) and perfectly predicted the absence of CIN2+. In women with a high-grade screening result (n = 37); 75.6% had CIN2+ and dual-stained curettings improved the PPV (96.5 vs 75.6%).

Conclusions

With high-grade screening and a TZ3, LLETZ appears safest as three quarters have CIN2+ . Women with low-grade screening and a TZ3 have a twofold increased risk of CIN2+ when compared to women where the TZ is visible. The use of dual-stained cytology may help identify those women who can be safely offered surveillance and those who require treatment.

SUBMITTER: Manley K 

PROVIDER: S-EPMC8727619 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Publications

The use of biomarkers and HPV genotyping to improve diagnostic accuracy in women with a transformation zone type 3.

Manley Kristyn K   Patel Amit A   Pawade Joya J   Glew Susan S   Hunt Katherine K   Villeneuve Nichole N   Mukonoweshuro Pinias P   Thompson Samantha S   Hoskins Helen H   López-Bernal Andres A   Wills Andrew A  

British journal of cancer 20211029 1


<h4>Background</h4>Twenty percent of women referred to colposcopy have a type 3 transformation zone-where colposcopic assessment for high-grade dysplasia (CIN2+) is not possible. This study examines the effectiveness of HPV biomarkers and genotyping in combination with techniques that sample an endocervical TZ.<h4>Methods</h4>A prospective diagnostic accuracy study. Women booked for large-loop excision (LLETZ) with squamous dyskaryosis, high-risk HPV and a TZ3 were recruited. Immediately prior t  ...[more]

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