Author/Editor		Xu, Lan; Benoy, Ina; Cuschieri, Kate S.; Poljak, Mario; Bonde, Jesper; Arbyn, Marc
Title		Accuracy of genotyping for HPV16 and 18 to triage women with low-grade squamous intraepithelial lesions
Type		članek
Vol. and No.		Letnik iss. 6, št. Vol. 19
Publication year		2019
Volume		str. 543-551
ISSN		1473-7159 - Expert review of molecular diagnostics
Language		eng
Abstract		Background: Genotyping for the most carcinogenic human papillomavirus (HPV) types (HPV16/HPV18) can identify high risk of underlying cervical precancer and guide further management. Research design and methods: A pooled analysis was performed of the clinical accuracy of high-risk HPV (hrHPV) testing and HPV16/18 genotyping in triage of women with low-grade squamous intraepithelial lesions (LSIL). Data regarding 24 assays evaluated in four VALGENT validation panels were used. Results: In women with LSIL, hrHPV had a pooled sensitivity for CIN2+ of 95.5% (95% CI: 91.0-97.8%) and a specificity of 25.3% (95% CI: 22.2-28.6%). HPV16/18 genotyping had a sensitivity and specificity for CIN2+ of 52.9% (95% CI: 48.4-57.4%) and 83.5% (95% CI: 79.9-86.5%), respectively. The average risk of CIN2+ was 46.1% when HPV16/18-positive, 15.5% in women who were HPV16/18-negative but positive for other hrHPV types and 4.3% for hrHPV-negative women. Conclusions: Triage of women with LSIL with HPV16/18 genotyping increases the positive predictive value compared to hrHPV testing but at the expense of lower sensitivity. Arguably, women testing positive for HPV16/18 need further clinical work-up. Whether colposcopy referral or further surveillance is recommended for women with other hrHPV types may depend on the post-test risk of precancer and the local risk-based decision thresholds.
Keywords		cervical cancer HPV genotyping intraepithelial lesions rak materničnega vratu genotipizacija HPV intraepitelne lezije