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KMID : 0358420150580020117
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Korean Journal of Obstetrics and Gynecology
2015 Volume.58 No. 2 p.117 ~ p.123
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Impact of age on the false negative rate of human papillomavirus DNA test in patients with atypical squamous cells of undetermined significance
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Won Kyu-Hee
Lee Jae-Yeon
Cho Hye-Yon
Suh Dong-Hoon
No Jae-Hong
Kim Yong-Beom
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Abstract
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Objective: Human papillomavirus (HPV) test was incorporated into the triage of lesser abnormal cervical cytologies: atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL). This study aimed to evaluate the impact of age on the efficacy of HPV testing in patients with lesser abnormal cervical cytologies.
Methods: A total of 439 patients with ASCUS or LSIL were included. The association between age groups and the diagnostic performances of HPV test for high-grade cervical intraepithelial neoplasia (CIN2+) was evaluated.
Results: Median age was 44 years (range, 17 to 75 years). ASCUS was more frequently observed in older patients while LSIL was more common in younger patients (P=0.002). CIN2+ was found in 11.3% (32/284) of the ASCUS patients and 12.9% (20/155) of patients with LSIL. Older patients with ASCUS showed lower HPV infection rates (P=0.025), but not LSIL (P=0.114). However, the prevalence of CIN2+ was similar between the age groups with ASCUS or LSIL. In patients with ASCUS, the false negative rate of HPV test for CIN2+ was 6.2%. The false negative rate of the HPV test became higher with increasing of the age after the age of 50 (P=0.034).
Conclusion: Our findings suggest that false negative rate of the HPV test for CIN2+ in ASCUS patients older than 50 years might become higher with increasing of the age. Negative HPV results in patients of the age >50 years with ASCUS should be carefully interpreted.
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KEYWORD
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Age, Atypical squamous cells of the cervix, Human papillomavirus DNA tests, Uterine cervical dysplasia
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