Analysis of the Relationship Between Cervical Cytology and Final Pathology Results in HPV 16 or HPV 18 Positive Patients: A Tertiary Center Experience

INTRODUCTION: To analyse the cytology and pathology results of HPV 16 or HPV 18 positive patients referred to our clinic as part of the national screening program.
METHODS: Data of patients with HPV 16 or HPV 18 positive who were referred to our Gynecologic Oncology Clinic between January 2014 and May 2017 were retrospectively reviewed. All patients underwent colposcopy. The highest grade lesion obtained from biopsy, endocervical curettage or excisional procedure results was accepted as the final pathology.
RESULTS: The mean age of the 720 patients included in the study was 41.96 ± 8.67, and the parity average was 2.39 ± 1.58. One hundred and thirty-two of them (18.3%) were menopausal, and 588 (81.7%) were premenopausal. The smear results of 138 patients could not be reached. Reached smear results were; normal or inflammation in 39 patients (55.3%), insufficient in 36 patients (5%), ASCUS in 91 patients (12.6%), LGSIL in 36 patients (5%), ASC-H in 11 patients (1.5%), HGSIL in 4 patients (0.6%), and AGC in 6 patients (0.8%). Distribution of abnormal smear results that cause CIN 2+ lesion in the final pathology were; ASCUS: 23 (25.3%), LGSIL: 13 (36.1%), ASC-H: 6 (54.5%), HGSIL: 4 (100%) and AGC: 2 (33.3%). More CIN 2+ lesions were detected in cases with abnormal cytology than those with normal cytology who are positive for HPV 16 or 18, and this difference was statistically significant (48 (32.4%) vs 60 (15.1%), OR: 2.7 ), p<0.01). The smear test was reported negative in 60 (55.6%) patients with CIN 2+, and three patients (75%) of the invasive cancers.
DISCUSSION AND CONCLUSION: Our results support the idea of performing colposcopic evaluation even if the cytology is normal in HPV 16 or 18 positive patients.