Objective: To detect the most prevalent human papillomavirus (HPV) genotypes samples of asymptomatic Peruvian women by analyzing the correlation betwe ienn c Pearvpiacnailc somlaeoaur (PAP)-stained cervical tests and PCR-sequencing. Methods: A total of 254 women attending routine gynecological examinations were included in pthaitsh ostluogdiys.t Tahned scalmaspsliefise dw ebrye tahnea Blyeztehde sbdya PsAysPt etmec.h HnPiqVu ea manpdli feicxaatmioinn ewda su nddoenre au msinicgr othsceo pprei mbeyr as specific for E1 region and positive specimens were confirmed by direct sequencing. Results: The prevalence of HPV was investigated in 254 cervical scrape samples by PCR. PAP smear showed that 94.9% cases had normal morphology and 5.1% had an inflammatory pattern; 2p0r.e5v%a lwenert eg efonuontydp teo ibne c ionrfreeclatetido nw iwthit hH PchVa, ncgoems pinri scienrgv i2c0a dl icfyfetorelongt yg.enotypes. HPV16 was the most Conclusions: Our results suggest the HPV is very frequent even in women with negative PAP, eannddo PceCrRvi csaele smasm tpol ebs.e Itdheen tbifeicsat toiopnt ioofn t htoe HdePtVe rgmeinnoety tphee inc aaussyamtipvteo magateinc tw oofm HePnV m ianyf eaclltoiown t hine nimatpulreaml henisttaotriyo no fo tfh ea pdpisroepasreia aten dp rthope hsyulbascetqicu emnet adseuvreelso pwmheicnht omf acye rhviacvael ma adliirgencatn icmy.pact / jdelvall@upc.edu.pe / This work has been partially supported by Universidad Peruana de Ciencias Aplicadas (UPC), Instituto de Investigación Nutricional and Instituto de Investigación de Efrnomfe rtmheed pardoegsr aImnf ecciosas, Lima, Peru. JR has a fellowship I3, of the ISCIII (Grant No. CES11/012), and LJDV from the Generalitat de Catalunya (2009SGR1208). / Revisión por pares

Introducción El sistema Bethesda se utiliza para clasificar los resultados de la prueba de Papanicolaou. Entre los resultados se tienen a las células ASC-US (células escamosas atípicas de significancia indeterminada) y ASC-H (células escamosas atípicas que no pueden descartar lesión intraepitelial). Se ha relacionado a estas células con neoplasia de cuello uterino; sin embargo, su asociación no ha sido muy estudiada en Perú. Objetivos Calcular la probabilidad de displasia severa, carcinoma in situ y cáncer de células escamosas, en mujeres con hallazgo citológico de ASC-H y ASC-US. Métodos Estudio observacional, transversal realizado en un hospital nivel IV en Lima-Perú, entre el 2012 y 2013, en el cual se evaluaron a 1060 pacientes con resultado de la prueba de Papanicolaou, Se realizó análisis bivariado y regresión logística binomial múltiple para evaluar la asociación. Se usó Chi cuadrado y se consideró el valor de p <0,05 como significativo. Resultados Se analizaron 1060 pruebas de Papanicolaou. La edad media fue 46,4 (DE: 13,2) años y 64,9% fueron menores de 50 años. La prevalencia de ASC-US fue 3,45% y la de ASC-H 0,32%. De 175 biopsias, el 22,9% presentó displasia moderada a severa o carcinoma escamoso. Se encontró asociación entre el hallazgo de ASC- H y la presencia de displasia moderada/severa (NIC 2/3), carcinoma in situ y carcinoma de células escamosas, en el estudio histopatológico (PR=2,39; IC(95%):1,49-3,81). Conclusión Dada la asociación encontrada, las mujeres con hallazgo de ASC-H, deben ser estudiadas de manera más profunda, con el fin de buscar displasia moderada/severa (NIC 2/3) o carcinoma de células escamosas. / Background The Bethesda system is used to classify Pap smear results. Some of the results are ASC-US (atypical squamous cells of undetermined significance) and ASC- H cells (atypical squamous cells cannot exclude intraepithelial lesion). It has been found an association between these results with cervical neoplasia; however they have not been well studied in Peru. Objectives To calculate the probability of severe dysplasia in situ or squamous cell cancer in women with cytology results of ASC-H and ASC-US. Methods An observational, cross-sectional study was carried out in a reference higher complexity health establishment in Lima, Peru (4th level), from 2012 to 2013, in which 1060 data of patients was analyzed. Bivariate and multiple binomial logistic regression analysis were performed. Chi square test was used and p-value < 0.05 was considered as significant. Results 1060 Pap smears were evaluated. Mean age was 46,4 (SD: 13,2) years and 64,9% were under 50 years old. ASC-US prevalence was 3,45% and ASC-H 0,32%. Out of 175 biopsies, 22,9% had moderate to severe dysplasia, carcinoma in situ or squamous carcinoma. There was an association between ASC-H finding and the presence of moderate/severe dysplasia (CIN 2/3), carcinoma in situ and squamous cell carcinoma (PR=2,39; CI(95%):1,49-3,81). Conclusion Given the association found, women with ASC-H findings should be further and thoroughly studied in order to look for moderate/severe dysplasia (CIN2/3) or squamous cell carcinoma.