Background: The ASC-US cytological result accounts for more than half of the abnormal cytology results. The detection and typing for HPV DNA is effetive and benefic in the management of ASC-US citology results, because the HPV type have the relationship with the severity of the squamous intraepithelial lesions. Objective: The aim of the study was to analyze the effectiveness of the HPV-DNA tests in the initial approach of women with ASC-US cytology.Background: The ASC-US cytological result accounts for more than half of the abnormal cytology results. The detection and typing for HPV DNA is effetive and benefic in the management of ASC-US citology results, because the HPV type have the relationship with the severity of the squamous intraepithelial lesions. Objective: The aim of the study was to analyze the effectiveness of the HPV-DNA tests in the initial approach of women with ASC-US cytology.
Methods: A cross-sectional cohort study was conducted with 100 women from the city of Rio de Janeiro with ASC-US cytology using liquid-based cytology, a colposcopy procedure and HPV DNA testing.
Results: The median age was 43 years. In 50% of the women were HPV positive. HPV genotyping test results showed that HPV types 51 and 16 were most frequent. 74% (37/50) of the women were infected with only one type, and 26% (13/50) were coinfected by two or more types. Most (60,9%) of the women with normal cytology were HPV negative, while all the women with severe cytology (LSIL, ASC-H, HSIL) were HPV positive. Most (64,1%) of the women with a normal colposcopy were HPV negative, while all of the women with an abnormal colposcopy (LSIL e HSIL) were HPV positive. There was cytocolposcopic concordance among 85% (59/69) of the women both tests normals. Only 30% (6/20) of the women with ASC-US cytology had an abnormal colposcopy. However, it was noted that cytocolposcopic concordance was obtained in 54,5% (6/11) of the women with severe cytology (ASC-H, LSIL, HSIL). Four women underwent biopsies with histological findings of NIC2 (2 cases), NIC3 (1 case) and microinvasive carcinoma (1 case).
Conclusion: Based on these data, it can be concluded that HPV DNA testing in the initial screening of women with ASC-US cytology may be an effective strategy.
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