Significance of HPV testing and colposcopic inspection on triaging ASCUS cytology

OBJECTIVE: To investigate the applicability of HR-HPV testing and colposcopic inspection on triaging atypical squamous cells of undetermined significance(ASCUS).METHODS:A total of 385 patients with ASCUS liquid-based cytology were undergone with HPV testing,colposcopic inspections and cervical biopsies.RESULTS: Of the 385 ASCUS cases,125 cases were histologically diagnosed as CIN,with a prevalence of 32.47%(125/385).Among which,35 cases,9.09%(35/385),were high-grade CIN(≥CINⅡ)or cervical cancer.For HPV testing,215 cases were HPV-positive,with a rate of 55.84%(215/385).The proportion of CIN for the group of HPV-positive was 46.98%(101/215),while the proportion for HPV-negative was 14.21%(24/170).The discrepancy was statistically significant(χ2=46.75,P0.01).On colposcopic inspection,28 cases were diagnosed with ≥CINⅡ.Among which,24 cases were ultimately confirmed,with a concordance of 85.71%.The sensitivity and negative predictive value of HR-HPV testing and colposcopy on triaging ASCUS with ≥CINⅡ lesions were 91.43%(32/35),98.24%(167/170) and 68.57%(24/35),96.92%(346/357) respectively.CONCLUSIONS: Histological diagnosis reveals a high proportion of CIN in ASCUS,including high-grade lesions and cervical cancer.HR-HPV testing is a sensitive tool to identify CIN among ASCUS patients.