Severe cervical inflammation and high-grade squamous intraepithelial lesions: a cross-sectional study
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GYNECOLOGIC ONCOLOGY
Severe cervical inflammation and high‑grade squamous intraepithelial lesions: a cross‑sectional study Tengfei Long1 · Lingli Long2 · Yaxiao Chen1 · Yubin Li3 · Ying Tuo4 · Yue Hu2 · lingling Xie1 · Gui He5 · Wen Zhao3 · Xiaofang Lu6 · Zhongqiu Lin1 Received: 2 April 2020 / Accepted: 16 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Inflammation has been reported as a facilitator in cervical oncogenesis, but the correlation between inflammation and cytological abnormality remains uncertain. The aim of this study was to investigate the correlation between inflammation and cytological abnormality. Methods ThinPrep cytological test (TCT) was used to detect cervical cytological abnormalities and inflammation degrees of 46,255 women in this prospective cross-sectional study. Histopathological examination was used to define the cervical intraepithelial neoplasia (CIN) in patients with cervical cytological abnormalities. Results The study revealed that 8.87% (4102/46,255) of TCT results had cytological abnormalities. The 4102 included cases were classified as the case group, including atypical squamous cells (ASC), low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL). Women with negative intraepithelial lesion or malignancy (NILM) were classified as the control group. About 88.83% (3644/4102) of women with cytological abnormalities showed inflammations. The rate of severe inflammation was significantly higher in the case group than the control group (23.86% vs. 2.0%, P = 0.000). Our results also showed that patients with severe inflammation had a significantly increasing incidence of cytological abnormality by 12.598 times and elevated the risk of HSIL by 756.47 times, compared to the inflammation negative group. Conclusion Severe inflammation was positively related to HSIL. Patients with severe cervical inflammation should be given more follow-ups and regular examinations and treated more carefully than those with mild or no inflammation. Keywords TCT · Cytological abnormality · Cervical intraepithelial neoplasia · Inflammation · HSIL Abbreviations CIN Cervical intraepithelial neoplasia TCT ThinPrep cytological test Tengfei Long, Lingli Long contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00404-020-05804-y) contains supplementary material, which is available to authorized users.
SYSU Sun Yat-Sen University ASC Atypical squamous cells LSIL Low-grade squamous intraepithelial lesions HSIL High-grade squamous intraepithelial lesions TBS The Bethesda system HPV Human papillomavirus AGC Atypical glandular cells of undetermined significance
* Zhongqiu Lin [email protected]
3
The Reproductive Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
Xiaofang Lu [email protected]
4
Department of Pathology, The First Affiliated Hospital, Sun Yat-Sen University, Gu
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