ArticleJournal of medical virology2025
Risk-Based Triage Strategy by Extended HPV Genotyping for Women With LSIL Cytology: A Real-World Study.
Article in Journal of medical virology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To evaluate the immediate risk of (pre)cancer for cytology low-grade squamous intraepithelial lesion (LSIL) women infected with or without specific HPV genotype and develop a risk-based management strategy. A total of 4567 LSIL women with extended HPV genotyping and colposcopy results were enrolled according to the inclusive and exclusive criteria. The distribution and immediate cervical intraepithelial neoplasia grade 2 or worse and 3+ or worse (CIN2+/3+) risks of specific HPV genotypes were assessed using Minimum Estimate, Any Type Estimate, and Hierarchical Attribution Estimate. A risk-based strategy was further established and evaluated. CIN2+/3+ were 729/328 cases, including 691/317 in 3398 HPV-positive and 38/11 in 1169 HPV-negative women. HPV16, 52, 58, and 18 were the most prevalent genotypes in both HPV-positive and CIN2+/3+ cases. HPV16, 73, and 33 carried the highest immediate CIN2+/3+ risk. A risk-based strategy was established, which suggested Group A (HPV 16, 33, 45, 31, 18, 58, 52, 35, 73, 82; with immediate CIN3+ risk of 4.08%-22.12%) for immediate colposcopy, Group B (HPV 59, 66, 56, 53) for 6-month follow-up or p16/Ki-67 dual stain or DNA methylation triage, while Group C (HPV 51, 68, 39, 26) for 1-year HPV repeat testing. Compared with conventional strategy, this new strategy showed significantly higher specificity (CIN2+: 52.16% vs. 29.47%, χ
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