Histologic Correlates of Glandular Abnormalities in Cervical Cytology Among Women With Human Immunodeficiency Virus
To estimate the frequency and histologic correlates of glandular abnormalities in cervical cytology among women with the human immunodeficiency virus (HIV) and to compare findings with those of women without HIV. In a cohort study of HIV-infected and uninfected women followed between 1994 and 2007,...
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| Veröffentlicht in: | Obstetrics and gynecology (New York. 1953) 2009-11, Vol.114 (5), p.1063-1068 |
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| creator | Massad, L Stewart Xie, Xianhong Darragh, Teresa M. Minkoff, Howard Levine, Alexandra M. D’Souza, Gypsyamber Cajigas, Anthony Colie, Christine Watts, D Heather Strickler, Howard D. |
| description | To estimate the frequency and histologic correlates of glandular abnormalities in cervical cytology among women with the human immunodeficiency virus (HIV) and to compare findings with those of women without HIV.
In a cohort study of HIV-infected and uninfected women followed between 1994 and 2007, Pap tests were obtained every 6 months. Glandular abnormalities, including atypical glandular cells (AGC), adenocarcinoma in situ (AIS), and adenocarcinoma, were identified and correlated with biopsy histology. Multivariate models to summarize data across visits used generalized estimating equations. The association of Pap and histology results was assessed using chi tests.
Of 48,362 Pap tests from 3,766 women, glandular abnormalities were found in 341 (0.7%) tests from 244 (6%) women, including 93 (1.0%) of 9,564 Pap tests among HIV-seropositive women with CD4 lymphocyte counts less than 250/mm, 103 (0.8%) of 13,023 tests among those with counts 250-500/mm, 68 (0.6%) of 12,470 tests among women with counts greater than 500/mm, and 70 (0.6%) of 11,769 tests among HIV-seronegative women (P for trend=.006). Colposcopy was documented for only 148 (61%) of 244 index Pap tests in women with glandular abnormalities. After index abnormal tests, endocervical curettings were obtained from 106 (43%) women, cervical biopsies from 76 (38%), and endometrial biopsies from 19 (8%). Squamous lesions predominated among histologic findings and histology results did not differ by HIV serostatus (P=.16).
Although immunosuppression increased the risk of glandular Pap test abnormalities in women with HIV, these remained uncommon. Compliance with management guidelines can improved.
II. |
| doi_str_mv | 10.1097/AOG.0b013e3181bc6ce0 |
| format | Article |
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In a cohort study of HIV-infected and uninfected women followed between 1994 and 2007, Pap tests were obtained every 6 months. Glandular abnormalities, including atypical glandular cells (AGC), adenocarcinoma in situ (AIS), and adenocarcinoma, were identified and correlated with biopsy histology. Multivariate models to summarize data across visits used generalized estimating equations. The association of Pap and histology results was assessed using chi tests.
Of 48,362 Pap tests from 3,766 women, glandular abnormalities were found in 341 (0.7%) tests from 244 (6%) women, including 93 (1.0%) of 9,564 Pap tests among HIV-seropositive women with CD4 lymphocyte counts less than 250/mm, 103 (0.8%) of 13,023 tests among those with counts 250-500/mm, 68 (0.6%) of 12,470 tests among women with counts greater than 500/mm, and 70 (0.6%) of 11,769 tests among HIV-seronegative women (P for trend=.006). Colposcopy was documented for only 148 (61%) of 244 index Pap tests in women with glandular abnormalities. After index abnormal tests, endocervical curettings were obtained from 106 (43%) women, cervical biopsies from 76 (38%), and endometrial biopsies from 19 (8%). Squamous lesions predominated among histologic findings and histology results did not differ by HIV serostatus (P=.16).
Although immunosuppression increased the risk of glandular Pap test abnormalities in women with HIV, these remained uncommon. Compliance with management guidelines can improved.
II.</description><identifier>ISSN: 0029-7844</identifier><identifier>EISSN: 1873-233X</identifier><identifier>DOI: 10.1097/AOG.0b013e3181bc6ce0</identifier><identifier>PMID: 20168108</identifier><identifier>CODEN: OBGNAS</identifier><language>eng</language><publisher>Hagerstown, MD: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adenocarcinoma - pathology ; Adenocarcinoma - virology ; Biological and medical sciences ; Biopsy ; CD4 Lymphocyte Count ; Cervix Uteri - pathology ; Colposcopy ; Endometrium - pathology ; Ethnicity ; Female ; Gynecology. Andrology. Obstetrics ; HIV Infections - complications ; HIV Infections - pathology ; HIV Seropositivity - pathology ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; Medical sciences ; Papillomavirus Infections - complications ; Smoking ; Uterine Cervical Dysplasia - pathology ; Uterine Cervical Neoplasms - complications ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - virology ; Vaginal Smears ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>Obstetrics and gynecology (New York. 1953), 2009-11, Vol.114 (5), p.1063-1068</ispartof><rights>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4126-c89cf8665524cb3543b3da24a14813e9651cd5a53bb282948831621744cff7cf3</citedby><cites>FETCH-LOGICAL-c4126-c89cf8665524cb3543b3da24a14813e9651cd5a53bb282948831621744cff7cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22081549$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20168108$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Massad, L Stewart</creatorcontrib><creatorcontrib>Xie, Xianhong</creatorcontrib><creatorcontrib>Darragh, Teresa M.</creatorcontrib><creatorcontrib>Minkoff, Howard</creatorcontrib><creatorcontrib>Levine, Alexandra M.</creatorcontrib><creatorcontrib>D’Souza, Gypsyamber</creatorcontrib><creatorcontrib>Cajigas, Anthony</creatorcontrib><creatorcontrib>Colie, Christine</creatorcontrib><creatorcontrib>Watts, D Heather</creatorcontrib><creatorcontrib>Strickler, Howard D.</creatorcontrib><title>Histologic Correlates of Glandular Abnormalities in Cervical Cytology Among Women With Human Immunodeficiency Virus</title><title>Obstetrics and gynecology (New York. 1953)</title><addtitle>Obstet Gynecol</addtitle><description>To estimate the frequency and histologic correlates of glandular abnormalities in cervical cytology among women with the human immunodeficiency virus (HIV) and to compare findings with those of women without HIV.
In a cohort study of HIV-infected and uninfected women followed between 1994 and 2007, Pap tests were obtained every 6 months. Glandular abnormalities, including atypical glandular cells (AGC), adenocarcinoma in situ (AIS), and adenocarcinoma, were identified and correlated with biopsy histology. Multivariate models to summarize data across visits used generalized estimating equations. The association of Pap and histology results was assessed using chi tests.
Of 48,362 Pap tests from 3,766 women, glandular abnormalities were found in 341 (0.7%) tests from 244 (6%) women, including 93 (1.0%) of 9,564 Pap tests among HIV-seropositive women with CD4 lymphocyte counts less than 250/mm, 103 (0.8%) of 13,023 tests among those with counts 250-500/mm, 68 (0.6%) of 12,470 tests among women with counts greater than 500/mm, and 70 (0.6%) of 11,769 tests among HIV-seronegative women (P for trend=.006). Colposcopy was documented for only 148 (61%) of 244 index Pap tests in women with glandular abnormalities. After index abnormal tests, endocervical curettings were obtained from 106 (43%) women, cervical biopsies from 76 (38%), and endometrial biopsies from 19 (8%). Squamous lesions predominated among histologic findings and histology results did not differ by HIV serostatus (P=.16).
Although immunosuppression increased the risk of glandular Pap test abnormalities in women with HIV, these remained uncommon. Compliance with management guidelines can improved.
II.</description><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - virology</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>CD4 Lymphocyte Count</subject><subject>Cervix Uteri - pathology</subject><subject>Colposcopy</subject><subject>Endometrium - pathology</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - pathology</subject><subject>HIV Seropositivity - pathology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infectious diseases</subject><subject>Medical sciences</subject><subject>Papillomavirus Infections - complications</subject><subject>Smoking</subject><subject>Uterine Cervical Dysplasia - pathology</subject><subject>Uterine Cervical Neoplasms - complications</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - virology</subject><subject>Vaginal Smears</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0029-7844</issn><issn>1873-233X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUstu1DAUtSpQOwz9A4S8QaxS_EycDdIoKjOVKnUDtDvLcZwZgx_FTlrN3-O2QwusbOuex733GIB3GJ1h1DafVlfrM9QjTA3FAve61gYdgQUWDa0IpTevwAIh0laNYOwEvMn5B0II1y09BiekXARGYgHyxuYpuri1GnYxJePUZDKMI1w7FYbZqQRXfYjJK2cnW0o2wM6kO6uVg93-kbuHKx_DFl5HbwK8ttMObmavArzwfg5xMKPV1gS9h99tmvNb8HpULpvTw7kE376cf-021eXV-qJbXVaaYVJXWrR6FHXNOWG6p5zRng6KMIWZKFO3Ncd64IrTvieCtEwIimuCG8b0ODZ6pEvw-Un3du69GbQJU1JO3ibrVdrLqKz8txLsTm7jnaSIEl7kluDjQSDFX7PJk_Q2a-PKZkycs2wobdCDZUGyJ6ROMedkxmcXjORDXLLEJf-Pq9De_93hM-lPPgXw4QBQuSx8TCpom19wBAnMWfvifx_dZFL-6eZ7k-TOKDftZAm-tMlRRRBqMS6v6vEv0N_scLD2</recordid><startdate>20091101</startdate><enddate>20091101</enddate><creator>Massad, L Stewart</creator><creator>Xie, Xianhong</creator><creator>Darragh, Teresa M.</creator><creator>Minkoff, Howard</creator><creator>Levine, Alexandra M.</creator><creator>D’Souza, Gypsyamber</creator><creator>Cajigas, Anthony</creator><creator>Colie, Christine</creator><creator>Watts, D Heather</creator><creator>Strickler, Howard D.</creator><general>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20091101</creationdate><title>Histologic Correlates of Glandular Abnormalities in Cervical Cytology Among Women With Human Immunodeficiency Virus</title><author>Massad, L Stewart ; Xie, Xianhong ; Darragh, Teresa M. ; Minkoff, Howard ; Levine, Alexandra M. ; D’Souza, Gypsyamber ; Cajigas, Anthony ; Colie, Christine ; Watts, D Heather ; Strickler, Howard D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4126-c89cf8665524cb3543b3da24a14813e9651cd5a53bb282948831621744cff7cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - virology</topic><topic>Biological and medical sciences</topic><topic>Biopsy</topic><topic>CD4 Lymphocyte Count</topic><topic>Cervix Uteri - pathology</topic><topic>Colposcopy</topic><topic>Endometrium - pathology</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - pathology</topic><topic>HIV Seropositivity - pathology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infectious diseases</topic><topic>Medical sciences</topic><topic>Papillomavirus Infections - complications</topic><topic>Smoking</topic><topic>Uterine Cervical Dysplasia - pathology</topic><topic>Uterine Cervical Neoplasms - complications</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - virology</topic><topic>Vaginal Smears</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Massad, L Stewart</creatorcontrib><creatorcontrib>Xie, Xianhong</creatorcontrib><creatorcontrib>Darragh, Teresa M.</creatorcontrib><creatorcontrib>Minkoff, Howard</creatorcontrib><creatorcontrib>Levine, Alexandra M.</creatorcontrib><creatorcontrib>D’Souza, Gypsyamber</creatorcontrib><creatorcontrib>Cajigas, Anthony</creatorcontrib><creatorcontrib>Colie, Christine</creatorcontrib><creatorcontrib>Watts, D Heather</creatorcontrib><creatorcontrib>Strickler, Howard D.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Massad, L Stewart</au><au>Xie, Xianhong</au><au>Darragh, Teresa M.</au><au>Minkoff, Howard</au><au>Levine, Alexandra M.</au><au>D’Souza, Gypsyamber</au><au>Cajigas, Anthony</au><au>Colie, Christine</au><au>Watts, D Heather</au><au>Strickler, Howard D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Histologic Correlates of Glandular Abnormalities in Cervical Cytology Among Women With Human Immunodeficiency Virus</atitle><jtitle>Obstetrics and gynecology (New York. 1953)</jtitle><addtitle>Obstet Gynecol</addtitle><date>2009-11-01</date><risdate>2009</risdate><volume>114</volume><issue>5</issue><spage>1063</spage><epage>1068</epage><pages>1063-1068</pages><issn>0029-7844</issn><eissn>1873-233X</eissn><coden>OBGNAS</coden><abstract>To estimate the frequency and histologic correlates of glandular abnormalities in cervical cytology among women with the human immunodeficiency virus (HIV) and to compare findings with those of women without HIV.
In a cohort study of HIV-infected and uninfected women followed between 1994 and 2007, Pap tests were obtained every 6 months. Glandular abnormalities, including atypical glandular cells (AGC), adenocarcinoma in situ (AIS), and adenocarcinoma, were identified and correlated with biopsy histology. Multivariate models to summarize data across visits used generalized estimating equations. The association of Pap and histology results was assessed using chi tests.
Of 48,362 Pap tests from 3,766 women, glandular abnormalities were found in 341 (0.7%) tests from 244 (6%) women, including 93 (1.0%) of 9,564 Pap tests among HIV-seropositive women with CD4 lymphocyte counts less than 250/mm, 103 (0.8%) of 13,023 tests among those with counts 250-500/mm, 68 (0.6%) of 12,470 tests among women with counts greater than 500/mm, and 70 (0.6%) of 11,769 tests among HIV-seronegative women (P for trend=.006). Colposcopy was documented for only 148 (61%) of 244 index Pap tests in women with glandular abnormalities. After index abnormal tests, endocervical curettings were obtained from 106 (43%) women, cervical biopsies from 76 (38%), and endometrial biopsies from 19 (8%). Squamous lesions predominated among histologic findings and histology results did not differ by HIV serostatus (P=.16).
Although immunosuppression increased the risk of glandular Pap test abnormalities in women with HIV, these remained uncommon. Compliance with management guidelines can improved.
II.</abstract><cop>Hagerstown, MD</cop><pub>by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>20168108</pmid><doi>10.1097/AOG.0b013e3181bc6ce0</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Obstetrics and gynecology (New York. 1953), 2009-11, Vol.114 (5), p.1063-1068 |
| issn | 0029-7844 1873-233X |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adenocarcinoma - pathology Adenocarcinoma - virology Biological and medical sciences Biopsy CD4 Lymphocyte Count Cervix Uteri - pathology Colposcopy Endometrium - pathology Ethnicity Female Gynecology. Andrology. Obstetrics HIV Infections - complications HIV Infections - pathology HIV Seropositivity - pathology Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infectious diseases Medical sciences Papillomavirus Infections - complications Smoking Uterine Cervical Dysplasia - pathology Uterine Cervical Neoplasms - complications Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - virology Vaginal Smears Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | Histologic Correlates of Glandular Abnormalities in Cervical Cytology Among Women With Human Immunodeficiency Virus |
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