| Objective: To analyze the cervical lesions of atypical squamous cells of undetermined significance(ASCUS)with positive or negative HPV subtypes of other high-risk types whose results of cervical cytology test were not clear.Reasonable surveillance and treatment were carried out for ASCUS without HPV infection or other high-risk HPV subtypes infection except HPV 16 and 18 subtypes.Methods: Human papillomavirus(HPV)typing and colposcopy were performed in 105 patients whose results of Thinprep cytology test(TCT)were ASCUS.Fixed-point biopsies were performed at suspicious sites under colposcopy,and multiple biopsies were performed if there was no obvious abnormality in appearance.The results of cervical pathology test were statistically analyzed.The detection rate of ASCUS,HPV infection and cervical lesions of ASCUS patients in different age groups were compared.Results: The age of ASCUS patients ranged from 22 to 65 years old,with the average age of(44.5±9.0)years old.The detection rate of ASCUS is high in the age group of >40years old.The detection rate of chronic cervicitis in ASCUS patients was 64.76%(68/105).Among them,HPV 16/18 positive accounted for 14.70%(10/68),other high-risk HPV positive accounted for 42.65%(29/68),HPV negative accounted for42.65%(29/68).The detection rate of CIN1 in ASCUS patients was 7.62%(8/105).Among them,HPV 16/18 positive accounted for 0.00%(0/8),other high-risk HPV positive accounted for 50.00%(4/8),HPV negative accounted for 50.00%(4/8).The detection rate of CIN2 in ASCUS patients was 9.53%(10/105).Among them,HPV 16/18 positive accounted for 10.00%(1/10),other high-risk HPV positive accounted for 80.00%(8/10),HPV negative accounted for 10.00%(1/10).The detection rate of CIN3 in ASCUS patients was 12.38%(13/105).Among them,HPV 16/18 positive accounted for 53.85%(7/13),other high-risk HPV positive accounted for 30.77%(4/13),HPV negative accounted for 15.38%(2/13).The detection rate of cervical cancer in ASCUS patients was 5.71%(6/105).Among them,HPV 16/18 positive accounted for 83.33%(5/6),other high-risk HPV positive accounted for 0.00%(0/6),HPV negative accounted for 16.67%(1/6).There was no significant difference in HPV constituent ratio between chronic cervicitis and CIN1,CIN2,CIN1 and CIN2(P>0.05).There were significant differences in HPV constituent ratio between chronic cervicitis and CIN3 or cervical cancer;between CIN1 and CIN3 or cervical cancer;between CIN2 and CIN3 or cervical cancer(P<0.05).There was no significant difference in HPV constituent ratio between CIN3 and cervical cancer(P>0.05).In addition,43 cases of ASCUS who underwent colposcopy,diagnosis and cervical biopsy by the same physician were collected.The diagnosis of high-grade intraepithelial lesions and cervical cancer by colposcopy was consistent with the pathological diagnosis of cervical biopsy.Conclusion: The pathology of cervical biopsy in patients with ASCUS was mainly chronic cervicitis,followed by high-grade squamous intraepithelial lesion(CIN2+CIN3),and there was also a certain detection rate of cervical cancer.Patients with cervical biopsy pathology result of chronic inflammation and CIN1 were mainly detected as other high-risk HPV infection and HPV negative,and patients with pathology result of CIN2 were mainly detected as other high-risk HPV infection,while Patients with pathology result of CIN3 or with cervical cancer were mainly detected as HPV 16/18 infection.Colposcopy can assist the diagnosis of ASCUS patients,the higher the grade of cervical lesions,the higher the colposcopy coincidence rate.ASCUS patients with other high-risk HPV positive are not necessary to be tested by colposcopy,but regular follow-up is needed,because ASCUS with other high-risk HPV positive may lead to the occurrence of CIN2.Patients with poor economic conditions and poor compliance can be tested by colposcopy,and those with HPV negative are easy to catch chronic cervicitis and CIN1,so regular follow-up is acceptable. |
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