Analysis Of Risk Factors For High-grade Epithelial Lesions In 236 Patients With ASCUS

Objective To identify the risk factors contributing to cervical intraepithelial neoplasia II(CINII)and above for patients with atypical squamous cells of undetermined significance(ASCUS).Methods The well-designed self-made questionnaire was used to analyze clinical data of 236 patients examined with liquid-based cervical cytology(TCT),detection of human papillomavirus genotype and vaginoscopy cervical biopsy.The related factors were evaluated with univariate and multivariate analysis.Results 68 cases with cervical intraepithelial neoplasia were confirmed by pathology,36 of which were diagnosed with CINII and above with a 15 percent of the total patients.The positive rate of high risk HPV(HR-HPV)genotypes was 55.51%.The lesion detecting rate of CINII and above was 25.19% and 2.86% for high risk HPV genotypes positive or negative patients respectively with a significant difference between two groups.High risk HPV genotypes could detect CINII and above with a sensitivity of 91.67% and a specificity of 97.14%.In addition,single factor analysis showed that age,age at first sex,the numbers of abortion and high risk HPV genotypes were related to CINII and above.Multivariate logistic regression analysis identified age at first sex,the numbers of abortion and high risk HPV genotypes acted as high risk factors for CINII and above.Conclusion HR-HPV testing are the practical methods for atypical squamous cells of undetermined significance,especially at the age of 30~40 years.First sex age under 20 years,having two or above abortions and HR-HPV genotypes are the independent risk factors for high grade-cervical lesion.