Clinicopathological significance of atypical squamous epithelium cells which cannot exclude high-grade squamous intraepithelial lesions in cervical cytology

Abstract

Objective To investigate clinicopathological significance of atypical squamous epithelium cells which cannot exclude high grade squamous intraepithelial lesions (ASC-H) in the diagnosis of cervical diseases. Methods The results of age, high-risk human papillomavirus DNA (hrHPV DNA) and cervical biopsy in 496 patients with ASC-H from March 2012 to December 2015 in Shanxi Dayi Hospital were analyzed. Results Among 496 ASC-H cases, the proportion of the patients between 40 and 49 years old was the highest [30.8% (153/496)]. HrHPV DNA was detected in 154 cases, and the positive rate was 79.2% (122/154), and the positive rate of patients at the age of 18 to 29 years old was the highest [84.2% (16/19)]. The detection rate of cervical intraepithelial neoplasia (CIN)Ⅱand above lesions in 124 cases with cervical biopsy was 66.9% (83/124), including 100 cases with hrHPV DNA positive (80.6%) and 24 cases with hrHPV DNA negative (19.4%). There were 71 cases (71.0%) of CINⅡ, CIN Ⅲ, early squamous carcinoma and squamous cell carcinomas in 100 hrHPV DNA positive patients with cervical biopsy. There were 12 cases (50.0%) of CINⅡ/Ⅲ changes in 24 hrHPV DNA negative patients with cervical biopsy, but none in early squamous carcinoma and squamous cell carcinomas was detected, and there was a significant difference between hrHPV DNA positive and negative patients (χ2=3.857, P < 0.05). The positive predictive value, negative predictive value, sensitivity and specificity of hrHPV DNA detection for diagnosis of CINⅡand above lesions were 85.5%, 29.3%, 71.0% and 50.0%, respectively. Conclusions ASC-H strongly predicts CINⅡand above lesions in cervical cytology. The detection of hrHPV DNA has a high positive predictive value for CINⅡand above lesions. Key words: Cervical lesion; Atypical squamous epithelium cells, cannot exclude high grade squamous intraepithelial lesions; High-risk human papillomavirus DNA; Biopsy