{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:38:07Z","timestamp":1778870287152,"version":"3.51.4"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,12,12]],"date-time":"2017-12-12T00:00:00Z","timestamp":1513036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Previous studies have indicated that negative Papanicolaou (Pap) tests can precede high\u2010grade cervical lesions (HGCL) on biopsy. This study aims to determine the contributing factors for cytologic discrepancy and the potential role of human papilloma virus (HPV) testing in risk evaluation of women with negative Pap tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of 42,797 Pap tests interpreted as negative for intraepithelial lesion or malignancy (NILM) from March 1, 2013 to December 30, 2014, 426 had available HPV testing and follow\u2010up biopsy. The NILM Pap tests with biopsy\u2010confirmed HGCL were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 426 cytology\u2010negative cases, the biopsies showed benign histology in 243 (57%), low\u2010grade squamous intraepithelial lesion in 157 (37%), HGCL in 22 (5%), and endometrial adenocarcinoma in 4 (1%) cases. The sensitivity\/specificity\/positive predictive values (PPV) of high\u2010risk HPV (hrHPV) and HPV16\/18 tests in predicting HGCL was 91%\/45%\/8% and 55%\/76%\/11%, respectively. Upon review of NILM Pap tests with biopsy\u2010confirmed HGCL, the contributing factors to negative cytology included absence of abnormal cells (12\/21, 57%) or diagnostic high\u2010grade cells (6\/21, 29%), unsatisfactory samples (2\/21, 10%), and interpretation variances (1\/21, 5%). Interpretation variances in three high\u2010risk lesions (1 HSIL, 2 ASC\u2010H) were influenced by marked obscuring inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study demonstrated that 5% of women underwent co\u2010testing with negative Pap tests had HGCL on follow\u2010up biopsy. Absence of diagnostic cells was the leading cause for cytology discrepancy and interpretation variances were influenced by marked obscuring inflammation. HPV testing and genotyping had limited value in risk stratification due to extremely low PPV. Focused rescreening of hrHPV\u2010positive NILM with obscuring factors may help reduce interpretation variances.<\/jats:p><\/jats:sec>","DOI":"10.1002\/dc.23874","type":"journal-article","created":{"date-parts":[[2017,12,12]],"date-time":"2017-12-12T09:09:52Z","timestamp":1513069792000},"page":"239-243","source":"Crossref","is-referenced-by-count":13,"title":["Negative Pap tests in women with high\u2010grade cervical lesions on follow\u2010up biopsies: Contributing factors and role of human papillomavirus genotyping"],"prefix":"10.1002","volume":"46","author":[{"given":"Steven","family":"Goodman","sequence":"first","affiliation":[{"name":"Department of Pathology and Genomic Medicine Houston Methodist Hospital Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxanne R.","family":"Mody","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St. Joseph's Hospital Denver 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