ThinPrep cytologic test combined with HPV typing to evaluate the degree of cervical diseases and the relationship between HPV typing and the pathological results of patients with atypical squamous cells of undetermined significance: a diagnostic test.

BACKGROUND

Persistent infection with high-risk human papilloma virus (HPV) is the main cause of cervical cancer. Cervical precancerous lesions last for long and are reversible. Thus, the effective way to prevent cervical cancer is to make a timely diagnosis and administer treatment in the precancerous stage. This study sought to explore the evaluation of cervical cytology by a ThinPrep cytologic test (TCT) combined with HPV typing in patients with cervical diseases, and the relationship between HPV typing and the pathological results of patients with atypical squamous cells of undetermined significance (ASCUS).

METHODS

The medical records of 414 patients who received outpatient treatment at the Suzhou Hospital of Traditional Chinese Medicine from February 2020 to February 2022. The pathological results of all cases were followed-up, and data on patients' age, menopause, pregnancy status, birth status, HPV typing, and HPV infection status were collected and statistically analyzed. The positive predictive value, negative predictive value, sensitivity, and specificity of the 2 detection methods were calculated. The factors associated with ASCUS pathological results were analyzed by logistic regression.

RESULTS

Among the 414 patients, 230 had positive vaginal tissue biopsy results, taking this as the gold standard, the diagnostic value of TCT and HPV were examined and compared. HPV typing had a slightly higher sensitivity and positive predictive value than TCT; however, the 2 methods combined had the highest sensitivity and positive predictive value. The univariate analysis showed that the age, HPV infection, and HPV typing in the group of chronic cervicitis differed significantly from the group of cervical intraepithelial neoplasia (CIN) II+/cervical carcinoma (P<0.05). The logistic regression analysis showed that HPV infection, being HPV-16 positive, and being HPV-18 positive were risk factors of ASCUS disease (P<0.05).

CONCLUSIONS

Compared to individual detection methods, TCT combined with HPV typing had a higher detection rate and screening accuracy for cervical diseases, and had the highest sensitivity and positive predictive value. HPV infection, being HPV-16 positive, and being HPV-18 positive are risk factors for ASCUS lesions. HPV typing detection can improve the accuracy of ASCUS shunt diagnosis and provide a reliable basis for the establishment of ASCUS shunt management.