Features of HPV infection and screening characteristics of high-risk HPV negative in patients with cervical high-grade squamous intraepithelial lesion: a retrospective analysis of 459 cases

Objective To investigate the infection features of high-risk human papillomavirus (HR-HPV) and screening characteristics of HR-HPV-negative cases in patients with cervical high-grade squamous intraepithelial lesion (HSIL). Methods A retrospective analysis was conducted on the screening results of 459 patients who were pathologically diagnosed as cervical HSIL in our hospital from January 2019 to August 2020. The positive detection rates of HR-HPV test, thinprep cytologic test (TCT), and their joint screening were compared among the patients, and the analysis of key points to avoid missed diagnosis were conducted in HR-HPV negative cases. Results Among the 459 HSIL patients, the single subtype infection accounted for 71.90% (330 cases), multiple infection 22.22% (102 cases); the positive rate of HR-HPV was 91.94% (422 cases), and the monotype infection with the highest positive rate was HPV subtype 16 (45.76%). The positive detection rates of the 3 tests were 77.34%, 64.27% and 82.79% respectively, with significant difference (P < 0.01). Moreover, 25 cases (67.57%) in the HR-HPV negative group had worse than ASCUS results of TCT, while 3 cases (8.11%) with ASCUS and 9 cases (24.32%) with negative TCT results were referred to colposcopy due to clinical symptoms, and 6 HR-HPV negative cases with normal colposcopy showed abnormal TCT results. Conclusion HR-HPV infection and monotype infection are predominant in cervical HSIL patients. The combined screening of HR-HPV and TCT has the highest positive diagnostic rate, while the HR-HPV negative patients usually have obvious clinical symptoms and TCT abnormalities.