Li Yang, Chen Yao, Lin Wanrun, Chen Keyi, Lv Weiguo, Zhou Feng
Department of Gynecologic Oncology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang Province, China, 310006.
Zhejiang Key Laboratory of Maternal and Infant Health, China, 310006.
J Cancer. 2025 Jan 1;16(2):398-405. doi: 10.7150/jca.99757. eCollection 2025.
: This study aims to assess the immediate risk of cervical intraepithelial neoplasia grade (CIN)3+ lesions in women with abnormal cervical glandular cytology. : A total of 403 women with abnormal cervical glandular cytology who underwent simultaneous HPV genotyping and cervical biopsy at the Zhejiang University School of Medicine Women's Hospital, China, between 2016 and 2020, were included in this study. The probability of CIN3+ lesions among women in each group was further analyzed. : Subsequently, 26.8% of women with abnormal cervical glandular cytology were diagnosed with CIN3+ lesions. The immediate risk of CIN3+ lesions in the atypical glandular cells, not otherwise specified (AGC-NOS), AGC-favor neoplasia (AGC-N), adenocarcinoma (AIS), and adenocarcinoma (AC) groups were 12.7%, 55.7%, 88.9%, and 92.0%, respectively. The immediate risk of CIN3+ lesions in the AGC-NOS group was significantly lower than in any other groups. The positive rates of hrHPV in the AGC-NOS, AGC-N, AIS, and AC groups were 26.4%, 68.6%, 66.7%, and 56.0%, respectively. The prevalence of CIN3+ in the HPV-16 or 18/45 positive group was significantly higher than in the group of other 11 types positive and hrHPV negative group. Notably, women under 30 years old with AGC-NOS had a low risk of CIN3+ lesions (2.4%). When considering HPV status, the immediate risk of CIN3+ lesions in HPV-negative women was 0.0%. : hrHPV genotype and age are valuable indicators to assess the risk of CIN3+ in women with abnormal cervical glandular cytology. Women under 30 years old with AGC-NOS/HPV-negative may have the opportunity to delay colposcopy if appropriate.
本研究旨在评估宫颈腺细胞异常的女性发生宫颈上皮内瘤变3级及以上（CIN3+）病变的即时风险。本研究纳入了2016年至2020年间在中国浙江大学医学院附属妇产科医院同时接受HPV基因分型和宫颈活检的403例宫颈腺细胞异常的女性。进一步分析了每组女性中CIN3+病变的概率。随后，26.8%的宫颈腺细胞异常女性被诊断为CIN3+病变。非典型腺细胞（AGC-NOS）、倾向肿瘤的非典型腺细胞（AGC-N）、原位腺癌（AIS）和腺癌（AC）组中CIN3+病变的即时风险分别为12.7%、55.7%、88.9%和92.0%。AGC-NOS组中CIN3+病变的即时风险显著低于其他任何组。AGC-NOS、AGC-N、AIS和AC组中高危型HPV（hrHPV）的阳性率分别为26.4%、68.6%、66.7%和56.0%。HPV-16或18/45阳性组中CIN3+的患病率显著高于其他11种类型阳性且hrHPV阴性组。值得注意的是，30岁以下AGC-NOS的女性发生CIN3+病变的风险较低（2.4%）。考虑HPV状态时，HPV阴性女性中CIN3+病变的即时风险为0.0%。hrHPV基因型和年龄是评估宫颈腺细胞异常女性发生CIN3+风险的重要指标。30岁以下AGC-NOS/HPV阴性的女性如果合适，可能有机会推迟阴道镜检查。
