Related Experiment Video For CIN2+
Updated: May 28, 2026
Chromogenic In Situ Hybridization as a Tool for HPV-Related Head and Neck Cancer Diagnosis
Published on: June 14, 2019
Koilocytosis in LSIL Cytology Has Limited Predictive Value for CIN2+ in HPV-Positive Women: Implications for
Yukimi Misawa1, Shuichi Mizuno1, Saeka Honda1
1Department of Medical Technology, Faculty of Health Sciences, Kyorin University, 5-4-1 Shimorenjaku, Mitaka-shi 181-8621, Japan.
Abstract:
Cervical cancer screening with high-risk human papillomavirus (HR-HPV) testing requires effective triage of HPV-positive women. Koilocytosis is a classic cytopathic effect of HPV infection, but its clinical significance in low-grade squamous intraepithelial lesions (LSILs) remains unclear. We retrospectively evaluated 157 HPV-positive women with LSIL cytology and follow-up data, including 140 women with concurrent biopsy results. Koilocytes were identified in 93/157 cases (59.2%) and were less frequent in HPV16/18-positive cases. Cervical intraepithelial neoplasia ≥ grade 2 (CIN2+) was detected in 9/84 koilocyte-positive cases (10.7%) and 16/56 koilocyte-negative cases (28.6%), whereas non-CIN findings were more common in koilocyte-positive cases. Koilocyte-positive cases also showed a longer time to regression from LSIL to negative for intraepithelial lesions or malignancy. These findings suggest that koilocytosis mainly reflects productive HPV infection and has limited utility for predicting CIN2+ in HPV-based screening triage. Excluding koilocytosis-driven low-grade cytological changes from triage positivity criteria may improve specificity and positive predictive value, supporting higher triage thresholds.
