Comparison of Colposcopic Biopsy Results of Patients Who have Cytomorphological Normal but HPV 16-18 or Other High-Risk HPV Subtypes Positive

Document Type : Research Articles


1 Atatürk Research and Training Hospital, Department of Gynecology and Obstetrics, İzmir Katip Çelebi University, Turkey.

2 School of Medicine, Department of Gynecology and Obstetrics, İzmir Katip Çelebi University, Turkey.


Objective: Current guidelines suggest annual co-test follow-up in non-16/18 high-risk HPV positive patients without
abnormal cytologic findings. Considering the relatively high false-negative rates of cervical cytology, a follow-up period
of one year might constitute an additional risk for development of cervical malignancies in these patients. The current
study aims to evaluate colposcopic biopsy results of cytologically normal patients detected to carry high risk HPV by
screening tests. Materials and Methods: A total of 160 patients with normal cervical cytology and high-risk HPV
subtypes who underwent colposcopic examination were included in the study. Patients were divided into two groups
according to their HPV results: HPV 16-18 and other types (non-16/18 high-risk subtypes). ECC, cervical biopsy, LEEP/
conization results were analyzed for both groups. Histopathological results of the groups were compared in terms of
≤LSIL, HSIL and cervical cancer rates. Results: Cervical biopsy results in the “16-18” group were assessed as HSIL
in 40 (48.2%) patients, LSIL in 6 patients (7.2%) and normal in 37 (44.6%) patients. ECC results revealed HSIL in
9 (10.8%) patients and LSIL in 1 (1.2%) patient. Nineteen out of 42 patients who underwent LEEP/conization had
HSIL (surgical margin positivity was reported in 4 cases), while 3 patients had LSIL. None of the cases had cervical
carcinoma. Conclusion: The present study detected that 15.6% of women infected with non-16/18 high-risk HPV
subgroups developed ≥HSIL lesions. Although this rate seems lower than HPV 16-18 group, it is still too high to be
overlooked. In conclusion, we suggest further clinical trials with larger number of patients to be conducted on this topic.


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