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Am J Clin Pathol. 2015 Dec;144(6):844-9. doi: 10.1309/AJCPUXLP7XD8OQYY.

The LAST guidelines in clinical practice: implementing recommendations for p16 use.

Author information

1
From the Hawaii Pathologists' Laboratory, Queen's Medical Center, Honolulu, and John A. Burns School of Medicine, University of Hawaii, Honolulu. lclinton@hawaii.edu.
2
From the Hawaii Pathologists' Laboratory, Queen's Medical Center, Honolulu, and.
3
John A. Burns School of Medicine, University of Hawaii, Honolulu.
4
From the Hawaii Pathologists' Laboratory, Queen's Medical Center, Honolulu, and John A. Burns School of Medicine, University of Hawaii, Honolulu.

Abstract

OBJECTIVES:

To determine the impact of implementing p16 Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions (LAST) guidelines, we compared p16 use and follow-up data before and after implementation of the guidelines.

METHODS:

We reviewed all cervical biopsy specimens diagnosed by two pathologists before and after implementation of the LAST guidelines and calculated the rate of and reason for p16 use across all biopsy specimens, high-grade squamous intraepithelial lesion (HSIL) detection, and follow-up.

RESULTS:

In total, 1,829 and 1,623 cervical biopsy specimens were reviewed in periods A and B, respectively. Overall p16 use increased from 2.8% to 6.2% (P < .001). Recommendations 2 and 4 increased from 0.16% and 0% of all cervical biopsy specimens in period A to 1.4% and 1.9% in period B, respectively (P < .0001). p16+ HSIL increased from 1.4% to 2.3% (P < .05). The positive predictive value of p16+ HSIL increased from 48% to 76% (P < .05).

CONCLUSIONS:

Implementation of the p16 LAST guidelines resulted in a significant increase in p16 use and a significant increase in the positive predictive value of p16+ HSIL.

KEYWORDS:

Cervical pathology; Gynecologic pathology; LAST guidelines; p16

PMID:
26572990
DOI:
10.1309/AJCPUXLP7XD8OQYY
[Indexed for MEDLINE]

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