Role for HPV testing in ASCUS: a cytologic-histologic correlation.

Human papilloma virus (HPV) Hybrid Capture II testing was introduced at our institution in mid-April, 2001. Relatively little data exists on the histologic follow-up of "high-risk HPV-positive ASCUS" patients without a previous abnormal Pap result. The results of the cytologic-histologic correlation of 50 patients over an 11-mo period are presented. Our results indicate that significant lesions may be discovered in patients of the "high-risk HPV-positive ASCUS" category who have no previous abnormal Pap history. Of the 50 patients presented in this study, histologic follow-up demonstrated evidence of squamous carcinoma in one patient (2%), high-grade squamous intraepithelial lesion (HSIL) in eight patients (16%), and low-grade squamous intraepithelial lesion (LSIL) in 19 patients (38%). The other 22 (44%) showed chronic cervicitis, reactive changes, or no pathologic changes. These findings suggest a more aggressive clinical approach may be warranted in the management of new onset ASCUS positive for high risk HPV.