The Value of High-risk Human Papillomavirus Detection in Women with Atypical Squamous Cell of Undetermined Significance

Objective:To evaluate the value of high-risk human papillomavirus(HPV) detection in women with atypical squamous cells of undetermined significance (ASCUS).Methods:High-risk HPV detection, multi-spot biopsy and endocervical curettage under colposcopy were performed on 351 patients whose thin-prep-1iquid-based cytology test(TCT) had been interpreted as ASCUS. The relationship between biopsy and HPV infection results were reviewed and analyzed.Results:①Of the 351 patients with cytological ASCUS, 69 cases were histologically confirmed as cervical intraepithelial neoplasia(CIN) (69/351,19.6%).Of the 69 cases,26 cases were histologically diagnosed as CINⅡ and high levels, accounting for 7.4%(26/351). ②Of the 351 cases,195 (55.6%) and 142(40.5%) were positive and negative respectively by high-risk HPV testing. The detection rate of CINⅡ or high levels in high-risk HPV positive group and negative group were 11.8% and 2.1%,respectively. There was significant difference between them(P0.05). The sensitivity, specificity, positive-predictive value and negative-predictive value of high-risk HPV detection for high grade cervical lesions were 88.46%, 48.00%, 11.79% and 98.07% respectively. ③Of the 195 cases with high-risk HPV positive,45.6% (89/195) were positive for HPV type 16 and 21.0%(41/195) were positive for HPV type 58. The rates of high grade lesions in patients with positive HPV16 were 7.6%, which were higher than those with positive HPV58(7.7% and 2.6%,P 0.05).Conclusions:High-risk HPV testing is an effective method in detection of high grade cervical lesions of ASCUS,especially colpscopy is proposed for all patients with positive HPV16,and the patients who has HPV negative or low-risk HPV positive need the regular closely follow-up.