HPV genotyping in patients undergoing colposcopy-guided cervical biopsy and ECC using reference smear and pathology results

Abstract Background: The cervical cytology, HPV presence and HPV genotyping used for cervical cancer screening are the guiding lights in predicting the risk of developing the disease now or in the near future and they can be used in deciding how to manage the patient. In our study, we aimed to determine the rate of HPV types in presence of abnormal cervical smear results and preinvasive lesions and to obtain data to help predict the risk of cervical pathology according to HPV genotyping in our population. Materials and methods: In this retrospective case series, 520 consecutive patients were included in the study who underwent colposcopy in the gynecologic oncology clinic. The most common HPV types were determined in patients with abnormal cytology results in cervical smear and with CIN2 or higher in cervical biopsy results. Results: A total of 279 patients were tested positive for HPV. 70 (25.1%) of the patients were HPV type 16, 34 (12.2%) were type 18 and 134 (47.0%) of the patients were tested positive for other high-risk HPV types. The most frequent other high-risk HPV type was type 39 (7.9%). Reference smear results identified 239 patients (48.8%) as ASCUS, 117 patients (23.9%) as LSIL, 19 patients (3.9%) as HSIL and 115 patients (23.5%) as normal. The incidence of HPV 16 and 18 infection in patients with abnormal smear results was 26.8%. Punch biopsy pathology results that revealed CIN1 was present in 48.4%, CIN2 or CIN3 in 8.1%, squamous cell carcinoma in 1.1% and cervicitis in 30.4% of the patients. In 89.2% of the patients whose biopsy results were CIN2-3 or squamous cell cancer, HPV types were 16 and 18. Conclusion: As types 16 and 18 positivity in patients with ASCUS was 26.8%, we suggest that performing colposcopy directly in all HPV positive cases as recommended in ASCCP guidelines must be questioned and HPV genotyping must be performed before colposcopy in patients with ASCUS.