Cancer Management and Research (Sep 2021)
HPV Genotype Specific and Age Stratified Immediate Prevalence of Cervical Precancers and Cancers in Women with NILM/hrHPV+: A Single Center Retrospective Study of 26,228 Cases
Abstract
Qin Liu,1,* Xin Zhou,1,* Xiaofei Zhang,1 Amanda Louise Strickland,2 wenxin zheng,3 Hao Chen,3 Feng Zhou1 1Department of Pathology, Zhejiang University School of Medicine Women’s Hospital, Hangzhou, 310006, People’s Republic of China; 2Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, 60611, USA; 3Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75235, USA*These authors contributed equally to this workCorrespondence: Feng ZhouDepartments of Pathology, Zhejiang University School of Medicine Women’s Hospital, Hangzhou, 310006, People’s Republic of ChinaTel +86-0571-89991702Email [email protected] ChenDepartment of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75235, USATel +1-469-419-1538Email [email protected]: To investigate the prevalence of precancers [high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS)] and cancers [squamous cell carcinoma (SCC) and adenocarcinoma (ADC)] in various high-risk human papillomavirus (hrHPV) genotypes or age groups among women with negative for intraepithelial lesion or malignancy (NILM) and hrHPV-positive pap results.Materials and Methods: In total, 26,228 women with NILM/hrHPV+ were included in the study. Among them, 5893 had immediate follow-up biopsy results available and were selected for further prevalence analysis.Results: About 7.6% and 0.7% women with NILM/hrHPV+ had HSIL and AIS, respectively. The prevalence of HSIL+ squamous lesions is significantly higher in HPV-16+ group than that in other genotype groups (p 65 years group (p < 0.0001). Overall, the prevalence of HSIL+ in younger women was significantly higher than that in older women when using a cutoff age of 40 years (9.3% vs 5.9%, p < 0.0001) or 50 years (8.6% vs 4.9%, p < 0.0001). No significant difference in AIS+ prevalence was found among different age groups (p = 0.611). Interestingly, the prevalence of SCC and ADC in older women (≥ 40 years, 0.3% and 0.3%, respectively) was significantly higher than that in younger women (< 40 years, 0% and 0.07%) (p = 0.001 for SCC; p = 0.02 for ADC).Conclusion: The significant risk of cervical precancers and cancers still exists in women with NILM/hrHPV+, notably the older patient group had a lower risk of cervical precancer, but higher risk of cancer. Therefore, HPV genotyping can be an effective supplemental tool to cytology, and patient age also needs to be considered in the clinical management of patient.Keywords: risk stratification, E6/E7 mRNA genotyping, NILM, hrHPV
