Ruizhe Chen

The distribution of colposcopy directed ectocervical biopsy and endocervical curettage results: a retrospective study of 47,134 cases

To investigate the distribution of colposcopy directed ectocervical biopsy and endocervical curettage (ECC) results, and to identify patients who may benefit from ECC. This retrospective study analyzed the clinical data of 47,134 patients who underwent colposcopy directed ectocervical biopsy and ECC between January 2021 and December 2023. Risk factors were identified by univariate and multivariate logistic analyses. The positive rate of the final histopathological diagnosis was 37.1% (17,503/47,134), with 22.8% (10,724/47,134) for low-grade squamous intraepithelial lesion (LSIL) and 14.4% (6,779/47,134) for high-grade squamous intraepithelial lesion (HSIL) or worse lesions (≥HSIL). At final diagnosis of LSIL, HSIL, adenocarcinoma ECC is a useful procedure for detecting additional endocervical lesions, and is recommended for patients aged ≥ 45, with high-risk HPV infection, ASC-H + or AGC cytology, and TZ3, as it will help reduce the rate of missed diagnosis of cervical lesions.

Risk-based triage strategy by extended HPV genotyping for women with ASC-US cytology

We attempted to evaluate the immediate high-grade squamous intraepithelial lesion-cervical intraepithelial neoplasia grade 2/3 or worse (HSIL-CIN2+/3+, hereafter referred to as CIN2+/3+) risk of specific human papillomavirus (HPV) genotype and form the precise risk-based triage strategy for atypical squamous cells of undetermined significance (ASC-US) women. The clinical data of ASC-US women who underwent HPV genotyping testing and colposcopy were retrospectively reviewed. The distribution and CIN2+/3+ risks of specific HPV genotype were assessed by three approaches. The risk-based triage strategy was further established, and its efficacy in detecting CIN2+/3+ was estimated. Totally, 5553 ASC-US women including 3648 HPV-positive and 1905 HPV-negative were analysed. CIN2+/3+ were 662/319 cases, including 639/306 HPV-positive and 23/13 HPV-negative women. HPV16, HPV52, HPV58 and HPV18 were always among the top 5 ranking genotypes, no matter in HPV-positive women or in HPV-positive CIN2+/3+ cases. HPV16 and HPV33 carried the highest risk, while HPV73 and 26 carried the least risk for CIN2+/3+. Based on the immediate CIN2+/3+ risk of specific HPV genotype, 18 HPVs were divided into three risk-stratified groups. Only women infected with HPVs included in group A were necessary for immediate colposcopy. Compared with conventional strategy, this new risk-based strategy not only had higher specificity (CIN2+: A new triage strategy for ASC-US women was successfully constructed based on CIN2+/3+ risks of 14 high-risk and 4 intermediate-risk HPVs, which could significantly reduce unnecessary colposcopies.