Screening Of Cervical Lesions Research Articles

Pioneering molecular screening for cervical precursor lesions and cervical cancer in sera

Cervical cancer is a significant public health issue in Mexico and many developing countries. Early detection is crucial for combating this disease. The official screening test for cervical cancer is cytology, but this technique faces several barriers, including methodological, educational, and sociocultural challenges. Liquid-based cytology is an improved version of this test, however it does not address the aforementioned complications. Biomarkers for cervical precursor lesions and cervical cancer can improve timely detection of the disease. A previous study from our group identified four circulating human proteins as potential biomarkers for these conditions. For molecular screening, we selected GAPDH as the biomarker for cervical precursor lesions and HNRNPA1 as the biomarker for cervical cancer -chosen from the three previously identified options based on antibody availability- to be detected in sera. Participants underwent a comprehensive panel of tests, including liquid-based cytology, PCR detection of Human papillomavirus (HPV), colposcopy, and histopathology -when applicable-. The last two tests were used as references for determining sensitivity and specificity, with histopathology being the gold standard for cervical cancer diagnosis. All the participants successfully received colposcopies (n = 99) and only those women with visible or suspected cervical lesions/malignancies were biopsied (n = 62). A subset of randomly selected biopsies underwent p16INK4a immunohistochemistry (n = 36). This study compares the performance of liquid-based cytology with the molecular screening. With colposcopy as reference, liquid-based cytology showed 30% sensitivity and 96% specificity, while the molecular screening showed 90% sensitivity and 43% specificity. With histopathology as reference, liquid-based cytology showed 21% sensitivity and 93% specificity, while the molecular screening showed 85% sensitivity and 61% specificity. The molecular screening outperformed the liquid-based cytology in several areas, including detecting true-positive cases, reducing false-negative cases by 34.62%, application time, simplicity of result´s categories, and acceptance among participants. An ideal screening test requires high sensitivity, maintains moderate specificity, and minimizes false negatives. Our proposed screening test meets these criteria, making it an ideal complement -or alternative- for cervical cancer screening.

Addressing Underscreening for Cervical Cancer among South Asian Women: Using Concept Mapping to Compare Service Provider and Service User Perspectives of Cervical Screening in Ontario, Canada

Cervical cancer is largely preventable through screening and treatment of cervical lesions. In the province of Ontario, South Asian women have some of the lowest rates of screening. The roles of service providers—those in healthcare and community services—and their interactions with screen-eligible people can greatly impact the uptake of screening. In our study, we used concept mapping (CM) to engage over 70 South Asian service users (i.e., those eligible for cervical screening) and service providers to identify a range of ideas and experiences that impact uptake of cervical screening for South Asian women, which were then rated by 45 participants in terms of ‘importance’ and ‘ease to address’ to encourage participation in cervical screening. Overall, ideas related to knowledge and education were rated as most important and easiest to address by both groups. Some differences were seen with South Asian service users valuing the importance of addressing ‘cultural beliefs and influences specific to sexual health’ more than service providers, while service providers valued the importance of addressing ‘lack of comfort and supportive relationships’ more than South Asian service users. Future interventions should target the knowledge and education needs of service users and increase service providers’ awareness of cultural beliefs and influences specific to sexual health.

Factors associated with positive human papillomavirus (HPV) test results in cervical precancer screening: a cross-sectional study at Souro Sanou National Teaching Hospital (SSNTH) in Bobo Dioulasso, Burkina Faso.

Human papilloma virus testing is a new method of screening for precancerous cervical lesions. Here we identified factors associated to the positive Human papilloma virus-testing in the context of cervical precancer screening at the Souro Sanou National Teaching Hospital in Burkina Faso. Conducted from June 2021-May 2022, this was a cross-sectional study, including patients aged between 25 and 55years-old and screened for precancerous lesions and received HPV-testing at the Department of Gynecology, Obstetrics and Reproductive Medicine (DGORM) of the SSNTH. The proportion of positive HPV-test was calculated, and we identified factors associated to positive HPV-test using logistic regression. Of the 759 patients came for precancerous lesions screening, 559 patients were included. Their mean-age was 38.8 ± 7.9years-old, 94.3% were from urban area and 50.3% identified as housewives. Regarding the past medical history, it noted: number of gestures (3.2 ± 2.0), parity (2.8 ± 1.9), number of living children (2.8 ± 1.9), having abortion experience (24.0%), age of first-sexual-intercourse(18.6 ± 2.3years), alcohol (9.1%) and tobacco (1.0%) consumption, sexually-transmitted-infection (27.0%), Human immunodeficiency virus (HIV)infection (5.0%); none had been vaccinated against HPV. Biologically, 16.6% [95% CI: 13.6-20] of the women had a positive HPV-test. The factors significantly associated with positive HPV-test were: occupation in the private sector [OR: 0.06(0.0-0.5); p < 0.001], having a sexually-transmitted-infection [OR: 3.9(2.0-7.7); p < 0.001], age of first-sexual-intercourse [OR: 0.7(0.6-0.9); p < 0.001], sexual-multiple-partnership [OR: 17.5(8.1-39.6); p < 0.001], and HIV status [OR: 13.2(4.4-40.5); p < 0.001]. These results call for health actions through the reinforcement for behavioral change mainly about sexually-transmitted-infections, and for the raising awareness of the population for the screening related to the precancerous lesions and HIV.

A Deep Learning Model for Cervical Optical Coherence Tomography Image Classification.

Objectives: Optical coherence tomography (OCT) has recently been used in gynecology to detect cervical lesions in vivo and proven more effective than colposcopy in clinical trials. However, most gynecologists are unfamiliar with this new imaging technique, requiring intelligent computer-aided diagnosis approaches to help them interpret cervical OCT images efficiently. This study aims to (1) develop a clinically-usable deep learning (DL)-based classification model of 3D OCT volumes from cervical tissue and (2) validate the DL model's effectiveness in detecting high-risk cervical lesions, including high-grade squamous intraepithelial lesions and cervical cancer. Method: The proposed DL model, designed based on the convolutional neural network architecture, combines a feature pyramid network (FPN) with texture encoding and deep supervision. We extracted, represent, and fused four-scale texture features to improve classification performance on high-risk local lesions. We also designed an auxiliary classification mechanism based on deep supervision to adjust the weight of each scale in FPN adaptively, enabling low-cost training of the whole model. Results: In the binary classification task detecting positive subjects with high-risk cervical lesions, our DL model achieved an 81.55% (95% CI, 72.70-88.51%) F1-score with 82.35% (95% CI, 69.13-91.60%) sensitivity and 81.48% (95% CI, 68.57-90.75%) specificity on the Renmin dataset, outperforming five experienced medical experts. It also achieved an 84.34% (95% CI, 74.71-91.39%) F1-score with 87.50% (95% CI, 73.20-95.81%) sensitivity and 90.59% (95% CI, 82.29-95.85%) specificity on the Huaxi dataset, comparable to the overall level of the best investigator. Moreover, our DL model provides visual diagnostic evidence of histomorphological and texture features learned in OCT images to assist gynecologists in making clinical decisions quickly. Conclusions: Our DL model holds great promise to be used in cervical lesion screening with OCT efficiently and effectively.

Unveiling the hidden link: fungi and HPV in cervical lesions.

Cervical cancer, primarily driven by high-risk human papillomavirus (HR-HPV) infection, ranks as the second most common cancer globally. Understanding combined infections' role, including Cervical fungi, is crucial in cervical carcinogenesis. This study aims to explore the potential correlation between HR-HPV, cervical fungi, and cervical cancer, while adjusting for various factors. The study population comprised patients undergoing colposcopy and conization due to abnormal cervical screening results. Clinical data including age, gravidity, HPV (human papillomavirus) genotypes, cervical pathology, and p16/Ki67 expression were extracted. Cervical TCT (ThinPrep Pap Test) and HPV testing are utilized for screening cervical lesions, with fungal presence suggested by TCT results. 5,528 participants were included in this study. Statistical analyses investigated associations between HPV/fungi co-infection and cervical lesions, employing multinomial logistic regression and interaction analysis. Co-infection with fungi and HPV may decrease the risk of cervical lesions compared to HPV infection alone. In the co-infection group, compared with HPV infection alone, the risk of low-grade squamous intraepithelial lesions (LSIL) was reduced by 27% (OR = 0.73, 95% CI: 0.59-0.90), the risk of high-grade squamous intraepithelial lesions (HSIL) was reduced by 35% (OR = 0.65, 95% CI: 0.51-0.82), and the risk of cervical cancer was reduced by 43% (OR = 0.57, 95% CI: 0.35-0.92). The interaction analysis revealed a negative interaction between fungal and HPV infections in the development of cervical cancer (RERI = -6.25, AP = -0.79, SI = 0.52), HSIL (RERI = -19.15, AP = -0.37, SI = 0.72) and LSIL (RERI = -1.87, AP = -0.33, SI = 0.71), suggesting a sub-additive effect, where the combined effect of the two infections was less than the sum of their individual effects. This indicates that fungal infection may attenuate the promoting effect of HPV on cervical lesions. In exploring the potential mechanism, we found that the co-infection group had significantly lower p16 positivity (54.6%) compared to the HPV-only group (60.2%) (p = 0.004), while there was no statistically significant difference in Ki67 positivity. This study unveils the intricate relationship between cervical fungi and HPV in cervical lesions. Co-infection with fungi and HPV against cervical lesions compared to HPV infection alone, indicating a novel clinical interaction. Lower p16 positivity in co-infection hints at a protective mechanism, urging further exploration.

Choosing the Appropriate HPV Testing and Treatment Algorithm: What Works for Different Contexts?

Cervical cancer can be eliminated, and the global community intends to achieve this goal in the next century. For this to successfully occur, concerted efforts to implement and scale-up available, evidence-based strategies including human papillomavirus vaccination, screening and treatment of precancerous lesions, and early detection and treatment for invasive cancers is paramount. While the World Health Organization has offered technical guidance and recommendations on implementation, several questions remain unanswered and require urgent high-quality research to inform policy and practice. We discuss the findings from the Cervical Cancer Screening and Treatment Algorithms pilot study in the context of the evidence synthesis conducted for the second edition of the World Health Organization guidelines for screening and treatment of cervical precancer lesions for cervical cancer prevention. Policymakers at the national level must consider the weight of evidence with country-level resources to make decisions on screening, triage, and treatment approaches. See related article by Sebitloane et al., p. 779.

Application of different methods for cervical cancer detection

Cervical cancer remains a widespread and challenging malignancy that affects women worldwide and poses significant clinical and public health issues. Since it is difficult to find early cervical lesions in the patient's own state, it is very important to apply appropriate and effective detection and screening for cervical cancer and precancerous lesions. This research investigates the development of cervical cancer and the various subtypes of HPV, which are the primary cause of cervical lesions. Combined with the investigation of the three most common clinical screening methods, including liquid-based thin-layer cell assay (TCT), human papillomavirus detection (HPV) and colposcopy detection operating methods and screening standards, data were used to comprehensively analyze the accuracy, sensitivity and specificity of single or combined screening of the three detection methods. This research examines various methods and technologies for cervical cancer screening, with the goal of determining their clinical effectiveness in detecting cervical lesions. Based on screening data, the results are positive and the methods are deemed suitable for early diagnosis of the condition. It is recommended that these screening tools be utilized in a clinical setting.

Analysis of the application value of HPV mRNA and DNA detection in early screening of cervical lesions

Aim: At present, COBAS human papillomavirus (HPV) and Aptima HPV screening are widely used to detect HPV infection. In this study, we compared and analyzed the positive rates of DNA and mRNA (n = 10,128 women). Methods: After HPV screening, colposcopy was performed. Subsequently, pathological analysis was conducted on the screening results. Results: In Aptima HPV 16 group, the proportion of pathological lesions ≥CIN2 was 32.69%, while in COBAS HPV group, it was 24.18% (p &lt; 0.05). Aptima HPV other risk types and COBAS HPV other risk types, the proportion of cases ≥CIN2 was 12.42 and 5.79%, respectively (p &lt; 0.001). Conclusion: The results illustrated that the Aptima HPV test detects more accurately clinically relevant lesions than the COBAS test.

Application of Three-dimensional Coding Network in Screening and Diagnosis of Cervical Precancerous Lesions

Globally, the incidence of cervical cancer ranks fourth among female malignant tumors, seriously threatening the physical and mental health of women. Early detection and early treatment can greatly reduce the mortality of cervical cancer "cytology /HPV test, colposcopy and cervical biopsy" is the main method for clinical diagnosis of cervical cancer. The progress of medical technology has significantly improved the early diagnosis of cervical cancer, but due to various factors, there are still many cases of missed diagnosis and misdiagnosis. In recent years, artificial intelligence has developed rapidly in the medical field, and has also shown good applicability in the screening and diagnosis of cervical cancer. In this paper, we design an mcs-SEM structure that contains both channels and space compression excitation modules, which can retain comprehensive spatial information at a low computational cost. Then, the structure is embedded in a three-dimensional coding network to realize the combination of two-dimensional convolutional neural network and three-dimensional spatial information, so as to predict the DVH in the complex distribution scenario of multi-endangered organs with higher accuracy.

Optimal Screening and Detection Strategies for Cervical Lesions: A Retrospective Study.

Background: Cervical cancer is the fourth most common cancer among women worldwide. Cervical cancer usually develops from human papillomavirus (HPV) infection, which leads to cervical intraepithelial neoplasia (CIN1/2/3) and eventually invasive cervical cancer. Therefore, early-screening and detection of cervical lesions are crucial for preventing and treating cervical cancer. However, different regions have different levels of medical resources and availability of diagnostic methods. There is a need to compare the efficiency of different methods and combinations for detecting cervical lesions and provide recommendations for the optimal screening and detection strategies. Methods: The current clinical methods for screening and detection of cervical lesions mainly include TruScreen (TS), Thinprep cytologic test (TCT), HPV testing, and colposcopy, but their sensitivity and specificity vary and there is no standard protocol recommended. In this study, we retrospectively reviewed 2286 female samples that underwent cervical biopsy and compared the efficiency of different methods and combinations for detecting cervical lesions. Results: HPV screening showed the highest sensitivity for identifying women with CIN2+ cervical lesions compared with other single methods. Our results also showed the importance and necessary of the secondary diagnostic test like TCT and TS as a triage method before colposcopy examination and guided biopsy. Conclusions: Our study provides recommendations for the optimal screening and detection strategies for cervical lesions in different regions with different levels of development. As a non-invasive, easily operated, and portable device, TS is a promising tool to replace TCT for detecting cervical lesions in the health care center with insufficient medical resources.

Screening and Diagnosis of High-Grade Cervical Lesions - Preliminary Results

Screening and Diagnosis of High-Grade Cervical Lesions - Preliminary Results

New Developments in Screening and Treatment of Cervical Squamous Intraepithelial Lesions

New Developments in Screening and Treatment of Cervical Squamous Intraepithelial Lesions

Evaluation of cervical cytological abnormalities in correlation with clinical findings in Iraqi patients

Abstract Objective: Many articles study the efficiency of pap smears in detecting cervical disease and precancerous lesions; however, in Iraq, only few researches study the clinic-pathological correlation in pap smear results. In this study, we will highlight the correlation of pap smears with the most important and frequent clinical data and findings on cervical examination. Materials and Methods: One hundred and twenty cases are collected from private clinics of gynecology in Al-Kut province during the interval (June 1, 2020, to February 28, 2021). Clinical history was obtained and pap smear test was examined by two pathologists. Data were analyzed using SPSS software program version 26. Results: There were significant statistical association between cytological abnormalities on pap smear test and age of the patient (P-value of 0.01), with low grade squamous intraepithelial lesion (LSIL) result showed the highest mean age of 46.91 as well as significant association with a number of live birth and a number of pregnancies with significant P value (&lt;0.001 and &lt;0.001) in the same order. Atypical squamous cells of undetermined significance were the most common cytological abnormality. Conclusion: Women should not delay their first screening pap test for more than 30 years of age since the mean age for LSIL (the most significant abnormality present in this study) was the age of 46. 91 ± 10.75. awareness about screening for cervical precancerous lesions should be increased especially among multiparous women and those more than 40 years of age.

Application of HPV-16 in Liquid-Based thin Layer Cytology of Host Genetic Lesions Based on AI Diagnostic Technology Presentation of Liquid

Nowadays, with the continuous improvement of people's health awareness and the increasing incidence of cancer year by year, the screening work of various clinical diseases, especially cancer, is also widely promoted. Cervical lesion screening is a common type. Cervical lesion screening is used to judge whether women have cervical lesions and increase attention to cervical lesions[1]. Proper prevention, diagnosis and treatment play an important role in ensuring women's health and life safety, and have been widely promoted in many places in our country. At the same time, in the screening of cervical lesions, how to adopt a more efficient and accurate diagnosis is very important to improve the screening effect of cervical lesions. With the rapid development of science and technology, AI and other advanced technologies have been gradually introduced in clinical disease diagnosis, especially in the liquid-based thin-layer cytology examination[2]. To further analyze the application effect of liquid based thin layer cytology AI diagnostic technology in the pathological diagnosis of cervical lesions. In this paper, we investigate the occurrence of HPV-16 integrated human host genome in cervical cancer and precancerous lesions and its application in cervical cancer screening. 50 cases of cervical cancer, 127 cases of LSIL, 83 cases of HSIL were collected, in addition, 22 cases of normal cervical epithelial tissues extracted by total hysterectomy were collected. The integration status of HPV-16 infection was detected by overlapping PCR.

High Precision Cervical Precancerous Lesion Classification Method Based on ConvNeXt.

Traditional cervical cancer diagnosis mainly relies on human papillomavirus (HPV) concentration testing. Considering that HPV concentrations vary from individual to individual and fluctuate over time, this method requires multiple tests, leading to high costs. Recently, some scholars have focused on the method of cervical cytology for diagnosis. However, cervical cancer cells have complex textural characteristics and small differences between different cell subtypes, which brings great challenges for high-precision screening of cervical cancer. In this paper, we propose a high-precision cervical cancer precancerous lesion screening classification method based on ConvNeXt, utilizing self-supervised data augmentation and ensemble learning strategies to achieve cervical cancer cell feature extraction and inter-class discrimination, respectively. We used the Deep Cervical Cytological Levels (DCCL) dataset, which includes 1167 cervical cytology specimens from participants aged 32 to 67, for algorithm training and validation. We tested our method on the DCCL dataset, and the final classification accuracy was 8.85% higher than that of previous advanced models, which means that our method has significant advantages compared to other advanced methods.

Benefits and harms of cervical screening, triage and treatment strategies in women living with HIV

To support a strategy to eliminate cervical cancer as a public health problem, the World Health Organisation (WHO) reviewed its guidelines for screening and treatment of cervical pre-cancerous lesions in 2021. Women living with HIV have 6-times the risk of cervical cancer compared to women in the general population, and we harnessed a model platform (‘Policy1-Cervix-HIV’) to evaluate the benefits and harms of a range of screening strategies for women living with HIV in Tanzania, a country with endemic HIV. Assuming 70% coverage, we found that 3-yearly primary HPV screening without triage would reduce age-standardised cervical cancer mortality rates by 72%, with a number needed to treat (NNT) of 38.7, to prevent a cervical cancer death. Triaging HPV positive women before treatment resulted in minimal loss of effectiveness and had more favorable NNTs (19.7–33.0). Screening using visual inspection with acetic acid (VIA) or cytology was less effective than primary HPV and, in the case of VIA, generated a far higher NNT of 107.5. These findings support the WHO 2021 recommendation that women living with HIV are screened with primary HPV testing in a screen-triage-and-treat approach starting at 25 years, with regular screening every 3–5 years.

Whole genome sequencing in high-grade cervical intraepithelial neoplasia patients from different ethnic groups in China.

Cervical cancer (CC) is the fourth most common cancer in women worldwide. It develops through precancerous lesions (cervical intraepithelial neoplasia (CIN), graded from low-grade (CIN1) to high-grade (CIN2-3)). It is well established that precancerous and cancerous cervical lesions are caused by a persistent infection with high-risk types of the human papilloma virus (hrHPV). To have a deeper understanding of the pathogenesis of CIN and CC, we systematically analyzed the landscape of genomic alterations and HPV integration profiles in high-grade CIN2/3. We performed deep whole genome sequencing on exfoliated cervical cells and matched peripheral blood samples from a cohort of 51 Chinese patients (of whom 35 were HPV+) with high-grade CIN from 3 ethnic groups and constructed strict integrated workflow of genomic analysis. In addition, the HPV types and integration breakpoints in the exfoliated cervical cells from these patients were examined. Genomic analysis identified 6 significantly mutated genes (SMGs), including CDKN2A, PIK3CB, FAM20A, RABEP1, TMPRSS2 and SS18L1, in 51 CIN2/3 samples. As none of them had previously been identified as SMGs in the Cancer Genome Atlas cervical squamous cell carcinoma and endocervical adenocarcinoma (TCGA-CESC) cohort, future studies with larger sample size of CINs may be needed to validate our findings. Mutational signature analysis showed that mutational signatures of CINs were dramatically different from CCs, highlighting their different mutational processes and etiologies. Moreover, non-silent somatic mutations were detected in all of the CIN2/3 samples, and 88% of these mutations occurred in genes that also mutated in CCs of TCGA cohort. CIN2 samples had significantly less non-silent mutations than CIN3 samples (P = .0006). Gene ontology and pathway level analysis revealed that functions of mutated genes were significantly associated with tumorigenesis, thus these genes may be involved in the development and progression of CC. HPV integration breakpoints occurred in 28.6% of the CIN2/3 samples with HPV infection. Integrations of common high risk HPV types in CCs, including HPV16, 52, 58 and 68, also occurred in the CIN samples. Our results lay the groundwork for a deeper understanding of the molecular mechanisms underlying the pathogenesis of CC and pave the way for new tools for screening, diagnosis and treatment of cervical precancerous and cancerous lesions.

Precancerous cervical lesion screening acceptance among women in Eastern Ethiopia

ObjectiveThis study assessed perceived barriers, precancerous cervical lesion screening acceptance, and associated factors among women in Eastern Ethiopia.SettingThis study was conducted in Hiwot Fana Specialized Hospital and Jugal Hospital.Study designThis...

Analysis of the Clinical Application Value of Colposcopy Biopsy in the Screening of Cervical Precancerous Lesions

Objective: To analyze the value of colposcopy biopsy in the screening of cervical precancerous lesions. Methods: 5,000 patients with suspected cervical precancerous lesions were used as samples. From January 2020 to December 2022, pathological examination and colposcopy biopsy were carried out, and the value of colposcopy biopsy was analyzed. Results: 1,503 cases were positive and 3,497 cases were negative by pathology, whereas 1,432 cases were positive and 3,568 cases were negative by colposcopy biopsy. The diagnostic sensitivity, specificity, and accuracy of colposcopy biopsy were 99.69%, 94.54%, and 97.78%, respectively. Cervicitis, CIN Ⅰ grade, CIN Ⅱ grade, CIN Ⅲ grade, and cervical cancer had no statistical difference with the pathological examination (P &gt; 0.05). Conclusion: The colposcopy biopsy scheme is used in the screening of cervical precancerous lesions, the detection accuracy is high in consistency with the pathological results, the risk of missed diagnosis and misdiagnosis is low, and it is efficient and feasible.

Joint Detection of High-Risk HPV E6/E7 mRNA and HC2 HPV-DNA in Cervical Lesions Screening

<i>Objective</i> To explore the value of joint detection of high-risk HPV E6/E7 mRNA and HC2 HPV-DNA to the screening of cervical lesions. <i>Methods</i> Totally 869 patients were divided into low-grade squamous intraepithelial lesions negative group including normal, inflammation and low-grade squamous intraepithelial lesions, and high-grade squamous intraepithelial lesions (HSIL) positive group including HSIL, squamous cell carcinoma and adenocarcinoma confirmed by ThinPrep cytologic test, HC2 HPV-DNA, high-risk HPV E6/E7 mRNA detection and colposcopy biopsy. The pathological result on HSIL positive was as the gold standard to evaluate the value of joint detection of HC2 HPV-DNA and high-risk HPV E6/E7 mRNA to the screening of cervical cancer. <i>Results</i> The positive rates of HPV E6/E7 mRNA and HPV-DNA detection in 869 patients were 46.1% and 61.3%, and increased with the severity of cytological grade and cervical level (<I>P</I><0.05). The sensitivity and specificity of HPV E6/E7 mRNA were 97.4% and 64.9%, higher than those of HPV-DNA (89.0%, 44.6%) (<I>P</I><0.05). The sensitivity and specificity of joint detection of HPV E6/E7 mRNA and HPV-DNA were 99.3% and 56.7%. The overall consistency rate and positive consistency rate were higher for HSIL positive (87.6%, 87.0%) than those for HSIL negative (70.5%, 30.5%) (<I>P</I><0.05). <i>Conclusion</i> The positive expressions of HPV E6/E7 mRNA and HPV-DNA are closely correlated with the severity of cervical lesions, and the joint detection of them two has high sensitivity and specificity.