{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:29:19Z","timestamp":1790980159296,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,4,17]],"date-time":"2015-04-17T00:00:00Z","timestamp":1429228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Testing for the presence of the human papillomavirus (HPV) is widely accepted for triaging Papanicolaou cytology results categorized as atypical squamous cells of undetermined significance (ASC\u2010US). In contrast, HPV testing has limited use in triaging cytological low\u2010grade squamous intraepithelial lesions (LSILs) due to prevalence rates of typically &gt;80%. In the current study, the authors assessed the diagnostic performance of p16\/Ki\u201067 dual\u2010stained cytology in triaging ASC\u2010US and LSIL cases within the prospective, multicentric Primary ASC\u2010US LSIL Marker Study (PALMS).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A total of 575 ASC\u2010US cases and 529 LSIL cases from a cohort of 27,349 women who were prospectively enrolled into the PALMS study in 5 European countries were tested with p16\/Ki\u201067 dual\u2010stained cytology and Hybrid Capture 2 (HC2) HPV testing. Colposcopy\u2010guided biopsy results of cervical intraepithelial neoplasia of grade 2 or worse (CIN2+) were used as clinical endpoints.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>p16\/Ki\u201067 dual\u2010stained cytology demonstrated comparable (ASC\u2010US: 94.4% for dual\u2010stained cytology vs 100% for HC2 testing; <jats:italic>P<\/jats:italic>\u2009=\u2009.317) or lower (LSIL: 85.7% for dual\u2010stained cytology vs 98.4% for HC2 testing; <jats:italic>P<\/jats:italic>\u2009=\u2009.005) sensitivity for CIN2+, but higher levels of specificity compared with HC2 HPV testing in both ASC\u2010US (78.7% vs 60.4%; <jats:italic>P<\/jats:italic>&lt;.001) and LSIL (53.3% vs 15.6%; <jats:italic>P<\/jats:italic>&lt;.001) cases. Positive predictive values for CIN2+ were substantially higher for dual\u2010stained cytology versus HC2 HPV testing, especially in LSIL, and in ASC\u2010US cases for women aged &lt;30 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The clinical usefulness and efficiency of triaging women with ASC\u2010US or LSIL Papanicolaou cytology results by p16\/Ki\u201067 dual\u2010stained cytology testing has been confirmed in this prospective, pan\u2010European study. The high positive predictive value of dual\u2010stained cytology for the presence of high\u2010grade CIN may help to reduce the number of unnecessary colposcopy referrals. <jats:bold><jats:italic>Cancer (Cancer Cytopathol)<\/jats:italic> 2015;123:373\u201381<\/jats:bold>. \u00a9 <jats:italic>2015 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21542","type":"journal-article","created":{"date-parts":[[2015,4,17]],"date-time":"2015-04-17T18:09:45Z","timestamp":1429294185000},"page":"373-381","source":"Crossref","is-referenced-by-count":103,"title":["Prospective evaluation of p16\/Ki\u201067 dual\u2010stained cytology for managing women with abnormal Papanicolaou cytology: PALMS study results"],"prefix":"10.1002","volume":"123","author":[{"given":"Christine","family":"Bergeron","sequence":"first","affiliation":[{"name":"Laboratoire Cerba Cergy Pontoise France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Ikenberg","sequence":"additional","affiliation":[{"name":"CytoMol Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Sideri","sequence":"additional","affiliation":[{"name":"European Institute of Oncology Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Denton","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust Bristol United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Bogers","sequence":"additional","affiliation":[{"name":"Algemeen Medisch Laboratorium BVBA Sonic Healthcare Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Schmidt","sequence":"additional","affiliation":[{"name":"synlab MVZ Pathologie Mannheim GmbH Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Alameda","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospital del Mar, Autonomous University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Keller","sequence":"additional","affiliation":[{"name":"Acomed statistik Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Rehm","sequence":"additional","affiliation":[{"name":"Roche mtm laboratories Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruediger","family":"Ridder","sequence":"additional","affiliation":[{"name":"Roche mtm laboratories Mannheim Germany"},{"name":"Ventana Medical Systems Inc Tucson Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the PALMS Study 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