Distribution of cervical lesions in high-risk HPV (hr-HPV) positive women with ASC-US: a retrospective single-center stu
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RESEARCH
Distribution of cervical lesions in high‑risk HPV (hr‑HPV) positive women with ASC‑US: a retrospective single‑center study in China Zhiling Wang1, Ying Gu1, Hui Wang1, Junyu Chen2, Yawen Zheng1, Baoxia Cui1 and Xingsheng Yang1*
Abstract Background: To investigate distributions of cervical lesions and factors associated with the severity of the cervical lesions in high-risk HPV (hr-HPV) positive women with atypical squamous cells of undetermined significance (ASC-US) cytology. Methods: Clinical information of 250,000 women who underwent HPV and cytological test was collected from January 2012 to January 2019. The association between the severity of the cervical lesions and hr-HPV genotypes, hr-HPV viral load, and ages, were analyzed in hr-HPV-positive/ASC-US women. Results: 3459 hr-HPV-positive/ASC-US women were enrolled in this study. Overall, 43.51% of women with ASC-US had normal histological results, 34.35% had high-grade squamous intraepithelial lesion (HSIL), and 1.30% had cervical cancer. The rate of HSIL or worse (HSIL+) in women with single HPV16 infection (63.09%) was the highest, followed by HPV33 (57.50%), HPV51 (36.11%), HPV58 (36.11%), HPV52 (28.28%), HPV18 (26.37%), HPV66 (19.35%), HPV39 (18.92%), HPV53 (15.00%), and HPV56 (8.51%). Detection rate of HSIL+ in low, intermediate and high viral-load groups were 15.87% (n = 30), 34.91% (n = 74) and 40.68% (n = 214) (Cochran-Armitage Trend test χ2 = 35.03, p 60 (3.41%) year-old groups were at increased risk for cervical cancer, compared with the ≤ 30-year-old group (0.61%). Conclusions: ASC-US women with HPV 16/18/33/51/52/58 single infection and multiple infections, as well as high HPV viral loads, have high risk of HSIL+. Keywords: Uterine cervical neoplasms, Human papillomavirus, Atypical squamous cells of undetermined significance, Cytology Background Cervical cancer is the third most common cancer among women worldwide and is the second most common to breast cancer in Asia [1]. Approximately 90% of cervical cancer deaths occur in developing countries, which is higher than that of developed countries [2]. Persistent *Correspondence: [email protected] 1 Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Wenhua West Road 44, Jinan, China Full list of author information is available at the end of the article
high-risk human papillomavirus (hr-HPV) infection is main cause of cervical lesions [3, 4]. At present, more than 200 genotypes of HPV have been isolated and the carcinogenicity of different HPV genotypes varies widely [5]. HPV16 causes 60% of cancers and 50% of precancerous lesions, however, HPV56 rarely causes cancer [6–8]. It takes 20–30 years from precancerous lesions to cervical cancer, and such long period provides doctors possibilities for intervention [9, 10]. Cervical cytology test and HPV test are the most common methods for cervical cancer screening.
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which
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