Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology
Objective We attempted to evaluate the immediate high-grade squamous intraepithelial lesion-cervical intraepithelial neoplasia grade 2/3 or worse (HSIL-CIN2+/3+, hereafter referred to as CIN2+/3+) risk of specific human papillomavirus (HPV) genotype and form the precise risk-based triage strategy fo...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2451183 |
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| author | Xuan Rao Yue-Han Wang Rui-Zhe Chen Qian-Qian Wu Xiao-Fei Zhang Yun-Feng Fu Xin-Yu Wang Xiao Li |
| author_facet | Xuan Rao Yue-Han Wang Rui-Zhe Chen Qian-Qian Wu Xiao-Fei Zhang Yun-Feng Fu Xin-Yu Wang Xiao Li |
| author_sort | Xuan Rao |
| collection | DOAJ |
| description | Objective We attempted to evaluate the immediate high-grade squamous intraepithelial lesion-cervical intraepithelial neoplasia grade 2/3 or worse (HSIL-CIN2+/3+, hereafter referred to as CIN2+/3+) risk of specific human papillomavirus (HPV) genotype and form the precise risk-based triage strategy for atypical squamous cells of undetermined significance (ASC-US) women.Methods The clinical data of ASC-US women who underwent HPV genotyping testing and colposcopy were retrospectively reviewed. The distribution and CIN2+/3+ risks of specific HPV genotype were assessed by three approaches. The risk-based triage strategy was further established, and its efficacy in detecting CIN2+/3+ was estimated.Results Totally, 5553 ASC-US women including 3648 HPV-positive and 1905 HPV-negative were analysed. CIN2+/3+ were 662/319 cases, including 639/306 HPV-positive and 23/13 HPV-negative women. HPV16, HPV52, HPV58 and HPV18 were always among the top 5 ranking genotypes, no matter in HPV-positive women or in HPV-positive CIN2+/3+ cases. HPV16 and HPV33 carried the highest risk, while HPV73 and 26 carried the least risk for CIN2+/3+. Based on the immediate CIN2+/3+ risk of specific HPV genotype, 18 HPVs were divided into three risk-stratified groups. Only women infected with HPVs included in group A were necessary for immediate colposcopy. Compared with conventional strategy, this new risk-based strategy not only had higher specificity (CIN2+: p = .00; CIN3+: p = .01) and positive predictive value (CIN2+: p = .00; CIN3+: p = .03) for detecting CIN2+/3+, but also needed fewer colposcopies to identify each CIN2+/3+.Conclusions A new triage strategy for ASC-US women was successfully constructed based on CIN2+/3+ risks of 14 high-risk and 4 intermediate-risk HPVs, which could significantly reduce unnecessary colposcopies. |
| format | Article |
| id | doaj-art-94ff378a70a849deb7b0519dcce4482c |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-94ff378a70a849deb7b0519dcce4482c2025-01-17T17:04:06ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2451183Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytologyXuan Rao0Yue-Han Wang1Rui-Zhe Chen2Qian-Qian Wu3Xiao-Fei Zhang4Yun-Feng Fu5Xin-Yu Wang6Xiao Li7Department of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaDepartment of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaDepartment of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaDepartment of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaDepartment of Pathology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaDepartment of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaDepartment of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaDepartment of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, ChinaObjective We attempted to evaluate the immediate high-grade squamous intraepithelial lesion-cervical intraepithelial neoplasia grade 2/3 or worse (HSIL-CIN2+/3+, hereafter referred to as CIN2+/3+) risk of specific human papillomavirus (HPV) genotype and form the precise risk-based triage strategy for atypical squamous cells of undetermined significance (ASC-US) women.Methods The clinical data of ASC-US women who underwent HPV genotyping testing and colposcopy were retrospectively reviewed. The distribution and CIN2+/3+ risks of specific HPV genotype were assessed by three approaches. The risk-based triage strategy was further established, and its efficacy in detecting CIN2+/3+ was estimated.Results Totally, 5553 ASC-US women including 3648 HPV-positive and 1905 HPV-negative were analysed. CIN2+/3+ were 662/319 cases, including 639/306 HPV-positive and 23/13 HPV-negative women. HPV16, HPV52, HPV58 and HPV18 were always among the top 5 ranking genotypes, no matter in HPV-positive women or in HPV-positive CIN2+/3+ cases. HPV16 and HPV33 carried the highest risk, while HPV73 and 26 carried the least risk for CIN2+/3+. Based on the immediate CIN2+/3+ risk of specific HPV genotype, 18 HPVs were divided into three risk-stratified groups. Only women infected with HPVs included in group A were necessary for immediate colposcopy. Compared with conventional strategy, this new risk-based strategy not only had higher specificity (CIN2+: p = .00; CIN3+: p = .01) and positive predictive value (CIN2+: p = .00; CIN3+: p = .03) for detecting CIN2+/3+, but also needed fewer colposcopies to identify each CIN2+/3+.Conclusions A new triage strategy for ASC-US women was successfully constructed based on CIN2+/3+ risks of 14 high-risk and 4 intermediate-risk HPVs, which could significantly reduce unnecessary colposcopies.https://www.tandfonline.com/doi/10.1080/07853890.2025.2451183Atypical squamous cells of undetermined significancehuman papillomavirusextended genotypingcolposcopycervical intraepithelial neoplasiarisk-based triage strategy |
| spellingShingle | Xuan Rao Yue-Han Wang Rui-Zhe Chen Qian-Qian Wu Xiao-Fei Zhang Yun-Feng Fu Xin-Yu Wang Xiao Li Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology Annals of Medicine Atypical squamous cells of undetermined significance human papillomavirus extended genotyping colposcopy cervical intraepithelial neoplasia risk-based triage strategy |
| title | Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology |
| title_full | Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology |
| title_fullStr | Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology |
| title_full_unstemmed | Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology |
| title_short | Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology |
| title_sort | risk based triage strategy by extended hpv genotyping for women with asc us cytology |
| topic | Atypical squamous cells of undetermined significance human papillomavirus extended genotyping colposcopy cervical intraepithelial neoplasia risk-based triage strategy |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2451183 |
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