Evaluation of high-risk HPV testing in triage of patients with atypical squamous cells of undetermined significance

Objective To evaluate high risk HPV testing in triage of women with atypical squamous cells of undetermined significance (ASCUS). Methods High-risk HPV testing was performed reflexively on 654 liquid-based pap smears that had been interpreted as ASCUS. Final diagnosis was made by biopsy under the colposcopy. Results Of the 654 women with cytological ASCUS, 411 (62. 8%) were positive by high-risk HPV testing. 58 cases were histologically confirmed as cervical intraepithelial neoplasia (CIN) (8. 9% ,58/654). Of the 58 cases, 43(74. 1 %) were diagnosed as CIN Ⅱ and CIN Ⅲ. By high-risk HPV testing, 80. 8% of CIN Ⅱ and 94. 1 % of CIN Ⅲ were positive. The sensitivity to detect CIN was 88. 9% with HPV triage, and 65. 5% without HPV testing. The sensitivity to detect CIN Ⅱ and CIN Ⅱ was 94. 1% by high-risk HPV testing and 65. 1 % by colposcopic examination. Conclusion HPV DNA testing of high-risk types is a method of high sensitivity for identification of CIN Ⅱ and CIN Ⅲ in women with ASCUS. The application of HPV DNA testing will result in a reduction of colposcopy and biospy referrals.