Analysis of colposcopic pathologic findings in 2943 cases of high-risk human papillomavirus-positive patients

GU Li-ping; ZHOU Xue-juan; WANG Dan-dan; LYU Jing-huan; ZHU Ting; MA Jun

doi:10.19538/j.fk2023120117

Abstract：Objective To explore the necessity of direct referral for colposcopic biopsy in patients positive for human papillomavirus(HPV)E6/E7mRNA.Methods A retrospective analysis was conducted at Suzhou Municipal Hospital from January 2020 to December 2020.A total of 2943 high-risk HPV positive patients were collected,of whom 2464 pa-tients were in HPV DNA positive group,869 patients were in HPV E6/E7mRNA positive group,and 390 patients were in both HPV DNA and E6/E7mRNA positive group.The detection rates of cervical lesions after colposcopic biopsy were compared and analyzed.Results(1)The detection rates of cervical low-grade squamous intraepithelial lesions(LSIL)in the HPV E6/E7 mRNA-positive group,HPV DNA-positive group,and both-positive group were 32.2％,32.9％,and 34.1％,respectively.The detection rates of high-grade squamous intraepithelial lesions(HSIL)in the cervix were 12.9％,13.4％,and 11.5％,respectively.The detection rates of cervical carcinoma in situ were 0.8％,0.6％,and 0.8％,respectively,and the detection rates of invasive carcinoma of the cervix were 0.6％,0.7％,and 0.8％,respective-ly.There was no statistically significant difference in the composition ratio of the cervical lesion detection rates among the three groups(P＞0.05).(2)In-depth analysis was made in patients whose ThinPrep cytologic test(TCT)was nega-tive(1889 patients),and it was found that:the detection rates of pathologic LSIL in the HPV E6/E7mRNA-posi-tive group,HPV DNA-positive group,and both-positive group were respectively 28.0％,27.3％,and 30.8％(P＞0.05),those of HSIL were 9.0％,8.8％,and 9.0％(P＞0.05),respectively,and for cervical cancer(including cervical carcinoma in situ),the rates were respectively 0.5％,0.4％,and 0.7％(P＞0.05).There was no statistical difference in the composition ratio of detection rates of cervical lesions among the 3 groups(P＞0.05).(3)In addition,after excluding HPV 16/18 positive patients,the detection rates of LSIL,HSIL and cervical cancer(including cervical carcinoma in situ)in the HPV E6/E7 mRNA positive group and HPV DNA positive group were 32.7％and 34.5％,10.0％and 10.2％,and 1.0％and 0.3％,respectively.The difference between the 2 groups was not statistically significant(P＞0.05).(4)Comparisons were made within the HPV E6/E7mRNA-positive group,the detection rates of HSIL in the HPV 16/18/45 E6/E7 mRNA-positive group and the HPV other subtypes E6/E7mRNA-positive group were respectively 26.5％and 10.0％(P＜0.001),and those of cervical cancer were 3.3％and 1.0％(P＜0.05).Conclusion There is a similar detection rate of cervical lesions between the HPV E6/E7mRNA-posi-tive group and the HPV DNA-positive group that met the indications for colposcopic biopsy.Thus,a referral to colposcop-ic examination is necessary for HPV E6/E7mRNA-positive patients.