{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T09:00:14Z","timestamp":1768640414684,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,11,21]],"date-time":"2016-11-21T00:00:00Z","timestamp":1479686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Fundacao de amparo ao ensino e pesquisa do estado de Sao Paulo(FAPESP)-Research Support Foundation of the State of Sao Paulo","award":["2010\/17645-6"],"award-info":[{"award-number":["2010\/17645-6"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Infections with multiple human papillomavirus (HPV) types (mHPV) in Papanicolaou tests have been reported but the histologic correlation and clinical meaning remains debatable.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors prospectively tested 37 HPV types using the Linear Array HPV Genotyping Test and correlated the results to cytology and histology findings in 260 women evaluated from June 2009 to October 2011 and followed for up to 60 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>HPV was detected in 148 of 235 samples (63%) and high\u2010risk HPV was detected in 132 samples (56%). mHPV infection was found to be twice as common as single HPV (sHPV) infection and was detected more frequently in low\u2010grade squamous intraepithelial lesion (LSIL) (48 of 83 samples [58%]) and high\u2010grade squamous intraepithelial lesion or invasive carcinoma (HSIL\u2009+\u2009(26 of 47 samples [55%]) compared with other categories (<jats:italic>P<\/jats:italic>&lt;.001). Of 34 LSIL\/cervical intraepithelial neoplasia 1 (CIN1) index cases, 13 of 21 patients with mHPV (61.9%) persisted on CIN1, whereas no histologic abnormality was detected during follow\u2010up in all 12 patients with sHPV infection (high risk or low risk) (<jats:italic>P<\/jats:italic>&lt;.001). Eighteen of 20 patients with HSIL\/cervical intraepithelial neoplasia 2 (CIN2) (90%) and high\u2010risk mHPV persisted on HSIL+\/CIN2\u2009+\u2009whereas 6 of 11 patients with sHPV infection did not demonstrate HSIL+\/CIN2\u2009+\u2009on follow\u2010up (54.5%) (<jats:italic>P<\/jats:italic>\u2009=\u2009.066). Approximately 40% of women with HSIL were infected by high\u2010risk HPV types other than types 16 or 18.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>High\u2010risk mHPV infection identified patients with persistent LSIL\/CIN1 and may to help identify patients at higher risk of disease progression to HSIL+\/CIN2+. Longer follow\u2010up will clarify the role of mHPV testing in patient care. <jats:bold><jats:italic>Cancer Cytopathol<\/jats:italic> 2017;125:138\u2013143.<\/jats:bold> \u00a9 <jats:italic>2016 American Cancer Society.<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1002\/cncy.21789","type":"journal-article","created":{"date-parts":[[2016,11,21]],"date-time":"2016-11-21T14:23:47Z","timestamp":1479738227000},"page":"138-143","source":"Crossref","is-referenced-by-count":49,"title":["Infections with multiple high\u2010risk HPV types are associated with high\u2010grade and persistent low\u2010grade intraepithelial lesions of the cervix"],"prefix":"10.1002","volume":"125","author":[{"given":"Louise","family":"De Brot","sequence":"first","affiliation":[{"name":"Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina Teixeira","family":"Moretti","sequence":"additional","affiliation":[{"name":"Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirce Maria","family":"Carraro","sequence":"additional","affiliation":[{"name":"Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando Augusto","family":"Soares","sequence":"additional","affiliation":[{"name":"Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael Malagoli","family":"Rocha","sequence":"additional","affiliation":[{"name":"Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glauco","family":"Baiocchi","sequence":"additional","affiliation":[{"name":"Department of Gynecology A.C. Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabela Werneck","family":"da Cunha","sequence":"additional","affiliation":[{"name":"Department of Pathology A.C. Camargo Cancer Center Sao Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor Piana","family":"de Andrade","sequence":"additional","affiliation":[{"name":"Department of Pathology A.C. 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