Cytology, High-Risk HPV Genotyping, and Histology in Cervical Pathology: A Retrospective Cohort Study.
4 affiliations
- 1Doctoral School of Medicine, Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania.
- 2Department I of Anatomy and Embryology, Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania.
- 3Department of Clinical Practical Skills, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania.
- 4Department XII, Obstetrics-Gynecology I, Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania.
Abstract
Background/Objectives: Cervical cancer prevention relies on cytology, high-risk human papillomavirus (HR-HPV) testing, and histological confirmation, but these modalities may disagree. We quantified test concordance and determinants of CIN2+ in a specialized gynecologic referral cohort with very low HPV vaccination coverage. Methods: We retrospectively analyzed 172 women evaluated for suspected or established cervical pathology between 2022 and 2024. Of these, 160 had a definitive HPV result and 130 had histology; histology-based performance analyses used complete cases and are conditional on biopsy verification. Cytology was categorized by the Bethesda system, HR-HPV genotypes were recorded, and histology was dichotomized as CIN2+ versus ≤CIN1. Results: Among 160 women with definitive HPV results, 109 (68.1%) were HPV-positive. HPV-positive women were younger (median 33 vs. 43 years, p < 0.001) and, among biopsied women, more frequently had CIN2+ (70.2% vs. 22.2%, p < 0.001). Cyto-histological agreement was fair (65.0%, κ = 0.32). HPV16/18 was strongly associated with CIN2+ (OR 6.85, 95% CI 2.54-18.49). Within histologically verified complete cases, HPV DNA positivity had the highest apparent sensitivity (91.7%), whereas HPV16/18 had the highest PPV (86.0%). Conclusions: Cytology and HR-HPV testing provide complementary information in this referral-enriched cohort. Because disease prevalence was high and biopsy verification was selective, predictive values and apparent diagnostic-performance estimates should not be extrapolated directly to population screening; external validation in primary-screening populations is required.
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BibTeX
@article{mazilu2026cytology,
title = {{Cytology, High-Risk HPV Genotyping, and Histology in Cervical Pathology: A Retrospective Cohort Study.}},
author = {Maria-Daniela Vasieș Mazilu and Elena-Lavinia Rusu and Jasmina-Sorina Chiriac and Alexandra-Corina Faur and Elena-Rodica Heredea and Veronica-Daniela Chiriac},
journal = {Diagnostics (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/diagnostics16193204},
url = {https://europepmc.org/article/MED/42882358},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cytology, High-Risk HPV Genotyping, and Histology in Cervical Pathology: A Retrospective Cohort Study.
AU - Maria-Daniela Vasieș Mazilu
AU - Elena-Lavinia Rusu
AU - Jasmina-Sorina Chiriac
AU - Alexandra-Corina Faur
AU - Elena-Rodica Heredea
AU - Veronica-Daniela Chiriac
PY - 2026
DA - 2026/10/02
JO - Diagnostics (Basel, Switzerland)
DO - 10.3390/diagnostics16193204
UR - https://europepmc.org/article/MED/42882358
AB - Background/Objectives: Cervical cancer prevention relies on cytology, high-risk human papillomavirus (HR-HPV) testing, and histological confirmation, but these modalities may disagree. We quantified test concordance and determinants of CIN2+ in a specialized gynecologic referral cohort with very low HPV vaccination coverage. Methods: We retrospectively analyzed 172 women evaluated for suspected or established cervical pathology between 2022 and 2024. Of these, 160 had a definitive HPV result and 130 had histology; histology-based performance analyses used complete cases and are conditional on biopsy verification. Cytology was categorized by the Bethesda system, HR-HPV genotypes were recorded, and histology was dichotomized as CIN2+ versus ≤CIN1. Results: Among 160 women with definitive HPV results, 109 (68.1%) were HPV-positive. HPV-positive women were younger (median 33 vs. 43 years, p < 0.001) and, among biopsied women, more frequently had CIN2+ (70.2% vs. 22.2%, p < 0.001). Cyto-histological agreement was fair (65.0%, κ = 0.32). HPV16/18 was strongly associated with CIN2+ (OR 6.85, 95% CI 2.54-18.49). Within histologically verified complete cases, HPV DNA positivity had the highest apparent sensitivity (91.7%), whereas HPV16/18 had the highest PPV (86.0%). Conclusions: Cytology and HR-HPV testing provide complementary information in this referral-enriched cohort. Because disease prevalence was high and biopsy verification was selective, predictive values and apparent diagnostic-performance estimates should not be extrapolated directly to population screening; external validation in primary-screening populations is required.
SN - 2075-4418
ER -