The Significance of Extended HPV Genotyping for Detecting Endocervical Glandular Neoplasia for Atypical Glandular Cells
Bibliographic record
Abstract
OBJECTIVES: This study aims to evaluate the risk of cervical glandular neoplasia with extended high-risk human papillomavirus (hrHPV) genotyping, in patients with atypical glandular cells (AGC) cytology. METHODS: Cervical AGC cases with concurrent extended HPV genotyping between October 2017 and October 2023 were retrieved from the archives of Department of Pathology, Obstetrics, and Gynecology Hospital of Fudan University (OGHFU). RESULTS: A total of 497 AGC cases with extended hrHPV genotyping showed an hrHPV-positive rate of 32.0%. The top 4 hrHPV types were HPV18, 16, 52, and 59. A total of 304 cases had histological follow-up. A total of 72 cases (23.7%) had cervical adenocarcinoma in situ/cervical intraepithelial neoplasia3 or worse (AIS/CIN3+) lesions with 43 endocervical carcinoma (EC-ADC), 28 AIS, and 1 CIN3. Cervical AIS/CIN3+ lesions were detected in 50.5% (55/109) of the hrHPV-positive group. Women with HPV18/16/45 positivity had 77.6% cumulative risk of cervical AIS/CIN3 + lesions (52/67), accounting for 94.6% (52/55) of the total hrHPV-associated cervical AIS/CIN3+ lesions. For all 15 other hrHPV types, the overall risk of AIS/CIN3+ was 7.1% (3/42 cases). The sensitivity, specificity, PPV, and NPV of the composite HPV18/16/45 group for detecting endocervical glandular neoplasia was 71.8%, 93.1%, 76.1%, and 91.6%, respectively. Endocervical carcinoma was found in 17 of 195 (8.7%) women with negative hrHPV testing, accounting for 39.5% EC-ADC (17/43) cases. CONCLUSIONS: Atypical glandular cells was rarely related to CIN3. Atypical glandular cells was strongly related to AIS and EC-ADC. Women aged 30-49 years had highest risk for AIS/CIN3+ lesions. Although HPV test can be helpful, there were still some cases of HPV-negative endocervical adenocarcinomas. Extended HPV genotyping in AGC cases identified certain HPV types associated with a higher risk of cervical glandular lesions, potentially assisting with risk stratification.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".