A Study of the Diagnostic Value of HPV Extended Genotyping Combined with Liquid-based Cytology Screening for High-grade Cervical Intraepithelial Lesions
Objective To explore the significance of combining human papillomavirus(HPV)infection and cytology testing in detecting cervical high-grade lesions.Methods We collected a total of 4131 cases of cervical biopsies from the Department of Pathology at Beijing Tiantan Hospital,Capital Medical University,between June 2019 and August 2023.We retrospectively analyzed the detection rates of high-grade cervical intraepithelial neoplasia(CIN 2 and above,CIN 2+)caused by single or multiple infections of HPV16/18,HPV31/33/52/58,and other high-risk HPV types,as well as liquid-based cytology testing.We evaluated differences among different groups and explored optimization strategies of risk stratification for HPV infection.Results Among cytology-negative single-type HPV infections,there were 1264 cases.The detection rates of high-grade lesions in the HPV 16/18 group,HPV 31/33/52/58 group,and other high-risk HPV groups decreased sequentially,at 2626％,16.33％,and 7.75％,respectively,with statistically significant differences.In cytology-negative multiple HPV infections,there were 577 cases,and the CIN2+detection rate in the HPV 16/18 group was 24.92％,significantly higher than that in the HPV 31/33/52/58 group(12.65％)and other high-risk multiple infection groups(7.31％),with no significant difference between the latter two groups.The CIN2+detection rates for cytology-positive HPV16/18,HPV31/33/52/58,and other high-risk single infections were 56.83％,41.74％,and 17.12％,respectively,with statistically significant differences.In cases with cytology results of ASC-US(atypical squamous cells of undetermined significance,ASC-US),the detection rates of high-grade lesions in these three groups were 44.11％,28.5％,and 9.7％,respectively,with x2 analysis results of 10.097,P＜0.001,and 25.303,P＜0.001.The CIN2+detection rates for HPV 16/18,HPV 31/33/52/58,and other high-risk multiple infections were 54.54％,37.50％,and 16.76％,respectively,with statistically significant differences.There were no statistically significant differences in the detection rates of high-grade lesions between single and multiple infections within the same type group,whether cytology was negative or positive.Conclusion This study suggests that risk stratification of other 12 high-risk HPV types can be further optimized,and the risk level of HPV31/33/52/58 is higher than that of other high-risk HPV groups.In cases with negative cytology,the follow-up time interval should be shortened.For infections with other high-risk HPV groups,a low-risk ASC-US cytology result can be managed with follow-up observations.
Precancerous lesions of the cervixHuman papillomavirusLiquid-based cytologyExtended HPV Genotyping
NETL
NSTL
万方数据
