Cytological distinction between high-risk and low-risk human papillomavirus infections in SurePath liquid-based cell preparations

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To investigate the correlation of various diagnostic cytological features in SurePath liquid-based cell preparations with high-risk human papillomavirus (HPV) infection.


Case–control study. SurePath specimens from 510 cases that had been tested for HPV DNA by Hybrid Capture 2 assay were retrieved and re-examined for 10 cytological features. Distribution of these features in high- and low-risk HPV types was compared and risk statistics were estimated. Effects of cervicitis on the manifestation of HPV cytological changes were adjusted by means of logistic regression.


Cytological features of nuclear hyperchromasia, multinucleation and atypical metaplastic cells were predominantly noted in high-risk HPV infection in the category of atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion. The odds ratios of these three features were 6–12 times higher in high-risk than low-risk HPV infection.


Some diagnostic cytological features can be used as markers in Pap smear screening for assessing the types of HPV infection.

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