TOWARD OBJECTIVE QUALITY ASSURANCE IN CERVICAL CYTOPATHOLOGY - CORRELATION OF CYTOPATHOLOGIC DIAGNOSES WITH DETECTION OF HIGH-RISK HUMAN PAPILLOMAVIRUS TYPES
Me. Sherman et al., TOWARD OBJECTIVE QUALITY ASSURANCE IN CERVICAL CYTOPATHOLOGY - CORRELATION OF CYTOPATHOLOGIC DIAGNOSES WITH DETECTION OF HIGH-RISK HUMAN PAPILLOMAVIRUS TYPES, American journal of clinical pathology, 102(2), 1994, pp. 182-187
Using The Bethesda System, five pathologists independently diagnosed 2
00 smears that originally had been classified as ''atypical,'' and the
results were correlated with concurrent detection of human papillomav
irus (HPV) DNA by Southern analysis and by polymerase chain reaction a
mplification. The smears were reclassified as benign reactive changes
(negative), atypical squamous cells of undetermined significance, or s
quamous intraepithelial lesion (SIL). Exact five-way cytologic agreeme
nt was achieved in only 29% of smears, and no slide was diagnosed as a
typical squamous cells of undetermined significance by all reviewers.
The detection of high-risk types of HPV correlated strongly with the l
ikelihood of a diagnosis of squamous intraepithelial lesion. High-risk
HPV types were detected in approximately 60% of smears reclassified a
s squamous intraepithelial lesion compared with 30% of those reclassif
ied as atypical squamous cells of undetermined significance and 10% of
negative smears (P < .001). Every smear unanimously diagnosed by the
panel as squamous intraepithelial lesion was associated with detectabl
e HPV DNA, mainly of high-risk types. Low-risk HPV DNA types were foun
d with similar frequency in all diagnostic categories assigned by the
reviewers. Based on the consistent relation between high-risk HPV dete
ction and diagnoses according to the Bethesda System, the authors conc
lude that HPV testing may have an important role in quality assurance
in cervical cytopathology.