The value of HPV integration testing for detecting cervical precancerous lesions or malignancies miss-diagnosed by colposcopy-directed biopsies: a cross-sectional study
Year: 2025
Type: preprint
Abstract: Objective: To assess the value of human papillomavirus (HPV) integration testing in predicting post-conization pathological upgrading to high-grade squamous intraepithelial lesions or worse (HSIL+) among patients whose colposcopy-directed biopsies revealed no precancerous lesions or malignancies. Design: A cross-sectional cohort study. Setting: Routine clinical work of HPV-associated cervical diseases. Population or Sample: A total of 417 HPV-positive patients whose colposcopy-directed biopsies revealed low-grade squamous intraepithelial lesions or normal (LSIL-) and subsequently underwent diagnostic cervical conization. Methods: The predictive value of HPV integration and cytology for discovering HSIL+ were analyzed and compared. Main Outcome Measures: Postoperative pathological results of HSIL+. Results: Among the 417 patients enrolled, postoperative pathological examinations revealed 91 cases of HSIL and 3 cases of cancer. A total of 76 patients tested positive for HPV integration, while 341 patients tested negative. Higher percentage of HSIL+ was revealed post-conization in those with positive HPV integration compared with those who tested negative (57.9% [46.5-69.3%] vs. 14.7% [11.0-18.3%], P value = 0.000). Compared to high-grade cytology, HPV integration had higher sensitivity (46.8%[36.7-56.9%] versus 24.5%[15.8-33.2%], P value = 0.003) and comparable specificity (90.1%[86.8-93.4%] versus 91.3%[88.3-94.4%]) in predicting postoperative pathological upgrading. The combination of high-grade cytology and HPV integration could detect 90.9% of missed HSIL+, and a double-negative result indicated histological LSIL- in 84.0% cases. Conclusions: HPV integration is a valuable predictor for detecting HSIL+ miss-diagnosed by colposcopy-directed biopsies.
Authors: Dongli Kong, Chun Gao, Ruqi Chen, Yi Ding, Wei Li, Xucui Zhuang, Min Lu, Cui Xing, Jianli Wu, Shimin Chen, Ting Hu, Hu Zhou, Xiaoyuan Huang, Nan Yu, Li Li
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7084123693
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