Triaging equivocal cytology of the cervix : identyfying women at risk
for high-grade cervical lesions
Wensveen, C.W.M.
Citation
Wensveen, C. W. M. (2006, June 13). Triaging equivocal cytology of the cervix : identyfying
women at risk for high-grade cervical lesions. Retrieved from
https://hdl.handle.net/1887/4435
Version:
Corrected Publisher’s Version
License:
Licence agreement concerning inclusion of doctoral thesis in the
Institutional Repository of the University of Leiden
Downloaded from:
https://hdl.handle.net/1887/4435
TRIAGING E Q U IV O C AL C Y TO L O GY O F TH E C E RV IX
TRIAGING EQUIVOCAL CYTOLOGY OF THE CERVIX
Identifying women at risk for high-grade cervical lesions
P R O E F S C H R IF T
ter verkrijging van
de graad van D octor aan de U niversiteit L eiden,
op gez ag van de R ector M agnificu s D r. D .D . B reimer,
hoogleraar in de facu lteit der Wisku nde en
N atu u rwetenschap p en en die der G eneesku nde,
volgens b eslu it van het C ollege voor P romoties
te verdedigen op dinsdag 1 3 ju ni 2 0 0 6
te klokke 1 6 :1 5 u u r
door
C elesta Walb u rga M aria Wensveen
geb oren te Wassenaar
Pro m o tie c o m m is s ie :
Promotor:
Prof. Dr. J .B. Trimbos
Copromotor:
Dr. M.J . K agie
Referent:
Prof. Dr. C.W. Burger (ErasmusMC)
Overige Leden: Prof. Dr. G.G. K enter
Prof. Dr. G.J . Fleuren
Ontwerp omslag en lay-out: Gerard Meijer
Printed by: A eroset Pre Press bv, Wateringen
ISBN-10: 90-902068 5-X
ISBN-13: 97 8 -90-902068 5-1
Jij mag zijn zoals je bent
om te worden wie je bent,
maar nog niet kunt zijn;
en je mag het worden
op jouw manier
en in jouw tijd.
Anna Terruwe
CONTENTS
Ch a p ter 1
Introduction 9
1.1 Eq uivocal cytology 11
1.1.1 Pap II, borderline dyskaryosis, ASCUS/ AGUS 11 1.1.2 Natural history and management of eq uivocal cytology 12
1.2 Colposcopy 13
1.2.1 Correlation between colposcopic characteristics and 13 histological outcome
1.2.2 Inter-observer agreement 14
1.3 Human papillomavirus 16
1.3.1 HPV and other risk factors 16 1.3.2 Epidemiology of genital HPV (natural history) 17
1.3.3 HPV tests 18
1.3.4 Viral Load of HPV 20
1.4 Biomarker Ki-67 21
1.5 Outline of the thesis 22
Ch a p ter 2
Detection of Cervical Intraepithelial Neoplasia in women with Atypical 33 Sq uamous or Glandular Cells of Undetermined Significance cytology:
A prospective study
Ch a p ter 3
Chapter 4
Can viral load, semi-quantitatively evaluated, of human papillomavirus 53 predict cytological or histological outcome in women with atypical
squamous or glandular cells of undetermined significance cytology?
Chapter 5
Viral load of human papillomavirus and high-grade cervical intraepithelial 65 neoplasia
Chapter 6
Combining HPV and MIB-1 test reduces the number of colposcopies in 77 women with equivocal borderline cytology
Chapter 7
Discussion and conclusions 87
