The utility of human papillomavirus testing in the management of atypical glandular cells on cytology.

Publication/Presentation Date

4-1-2009

Abstract

OBJECTIVE: To determine the value of human papillomavirus (HPV) testing for HPV-associated cervical disease (HPV-AD) and overall disease (atypical glandular cell [AGC]-associated cervical disease) in women with AGCs.

MATERIALS AND METHODS: A literature search was conducted from January 1993 through September 2007 using various AGC-related terms with the exploded Medical Subject Heading (MeSH) term "HPV." Findings from 7 studies were used to calculate disease rates according to HPV status.

RESULTS: The rate of AGC-associated cervical disease for 661 cases of AGC with concurrent HPV testing was 23.3%. The rate of HPV-AD was higher in HPV-positive, versus negative, cases (53% vs 3%, respectively). Human papillomavirus-positive, versus negative, status predicted a higher likelihood of a cervical intraepithelial neoplasia 2/3 lesion (odds ratio = 39.6, 95% CI = 17.9-87.4, p

CONCLUSIONS: All women with AGC should undergo a comprehensive initial examination regardless of HPV status. The presence of HPV identifies a group of women at higher risk for cervical disease who should be followed closely. Women positive for human papillomavirus with AGC and concurrent ASC/SIL are at even higher risk. If, after a comprehensive initial examination, women with AGC not-otherwise-specified and positive HPV have no identifiable disease, a cervical conization may be considered.

Volume

13

Issue

2

First Page

72

Last Page

78

ISSN

1526-0976

Disciplines

Medicine and Health Sciences

PubMedID

19387126

Department(s)

Department of Obstetrics and Gynecology

Document Type

Article

Link to Full Text

Share

COinS