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KMID : 0358420090520020203
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Korean Journal of Obstetrics and Gynecology
2009 Volume.52 No. 2 p.203 ~ p.211
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Diagnostic role of HPV DNA chip test in patient with atypical glandular cell cytology
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Kim Eun-Kyoung
Lee So-Myung
Park Seo-Yeon
Park Ju-Mi
Kang Woo-Dae
Kim Cheol-Hong
Cho Moon-Kyoung
Kim Jong-Woon
Kim Yoon-Ha
Kim Seok-Mo
Choi Ho-Sun
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Abstract
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Objective: This study was aimed to identify the diagnostic role of HPV DNA chip test that may predict high grade lesions in gladular cell abnormalities on cervical cytology.
Methods: This study was performed in 88 patients, who were reported for atypical glandular cells on liquid-based cytologic test and was done subsequent cervical biopsies in Chonnam National University Hospital, between January 2003 and June 2007. HPV DNA chip test was performed on residual material of previous liquid-based cytologic test. And it was compared with pathologic results.
Results: Of the 88 patients with atypical glandular cells, the distribution was as follows: 60 patients were reported as atypical glandular cells, not otherwise specified (AGC, NOS), 28 patients were reported as atypical glandular cells, favor neoplastics (AGC, favor neoplastics). Of the 88 patients with an AGC result, pathologic results were as follows: 47 patients (53.4%) had a clinically significant high grade lesions. Of this high grade lesions, 5 cases of high grade squamous intraepithelial lesion, CIN 2 & CIN 3 (83.4%, 5/6), 2 cases of SCC (66.7%, 2/3), 4 cases of AIS (80.0%, 4/5), and 11 cases of endocervical adenocarcinoma (69%, 11/16) were positive on HPV DNA chip test. The sensitivity of human
papilloma virus positivity to predict the presence of high grade lesion in cervix was 73.3%, specificity 85.3%, positive predictive value 78.5%, and negative predictive value 81.3%. There were 16 patients with endometrial cancer. Only 3 patients were HPV DNA chip positive. All of patients with endometrial cancer were over 35 years of age and almost have symptoms of abnormal genital bleeding except one.
Conclusion: HPV DNA detection was strongly associated with high grade lesions in women with atypical glandular cells on cervical pap smear. These results suggest that although there is no high grade lesion in patients with HPV positive AGC-NOS at initial work-up, meticulous search like cone biopsy should be done to find high grade lesion. If the women with a diagnosis of AGC on pap smear are over 35 years of age and has abnormal utero-vaginal bleeding, this patients needed to be evaluated with endometrial biopsy.
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KEYWORD
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Cervical pap smear, Atypical glandular cells, Human papilloma virus
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