Value of high‑risk human papillomavirus detection combined with colposcopy in the diagnosis of cervical cancer and precancerous lesions

Wang,Ping; Gao,Dongxia; Yu,Xiaoni; Zhu,Gaoxiang

doi:10.3892/ol.2024.14318

Value of high‑risk human papillomavirus detection combined with colposcopy in the diagnosis of cervical cancer and precancerous lesions

Authors:
- Ping Wang
- Dongxia Gao
- Xiaoni Yu
- Gaoxiang Zhu
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Affiliations: Jinan Licheng District Maternal and Child Health Care Family Planning Service Center, Jinan, Shandong 250100, P.R. China, Department of Obstetrics and Gynecology, Qingdao Geriatric Hospital [The West District of Qingdao Municipal Hospital (Group)], Qingdao, Shandong 266002, P.R. China
Published online on: February 29, 2024 https://doi.org/10.3892/ol.2024.14318
Article Number: 185
Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

In the present study, the diagnostic value of high risk‑human papillomavirus (HR‑HPV) combined with colposcopy for the detection of cervical cancer and precancerous lesions was evaluated. A total of 397 patients with confirmed cervical disease were enrolled between August 2020 and December 2021. According to the pathological diagnosis, the patients were divided into cervical intraepithelial neoplasia grade I (CIN I; n=153 cases), CIN II (n=101 cases), CIN III (n=86 cases) and cervical cancer (n=57 cases) groups. The HR‑HPV‑positive rate of the patients with different lesion types was compared, and the consistency of colposcopy and pathological examination results were assessed. For cervical cancer and precancerous lesions, the diagnostic value and efficacy of HR‑HPV testing, colposcopy and combined HR‑HPV testing and colposcopy examination were compared using pathological examination results as the gold standard. The results of the present study demonstrated that in patients with cervical cancer, the positive rate of HR‑HPV (100.00%; n=57/57) was higher than that in patients with precancerous lesions, and the positive rate of HR‑HPV in patients with CIN I type (36.60%, n=56/153) was lower than that in patients with CIN II (83.17%, n=84/101) and CIN III (82.56%, n=71/86) types (P<0.05). There was no significant difference in the HR‑HPV‑positive rate between patients with CIN II and CIN III (P>0.05). Cohen's κ coefficient for colposcopy examination and pathological examination of patients with cervical cancer and precancerous lesions was 0.622, the diagnostic accuracy was 90.43% (n=359/397), the positive predictive value was 65.57% (n=40/61), and the negative predictive value was 94.94% (n=319/336). Receiver operating characteristic curve analysis demonstrated that the area under the curve of the combined examination in the diagnosis of cervical cancer and precancerous lesions was 0.904, which was higher than that of colposcopy (0.820) or HR‑HPV testing (0.802) alone (P<0.05). The results of the present study indicated that HR‑HPV detection combined with colposcopy has diagnostic value for cervical cancer and precancerous lesions.

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1	Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, Arbyn M, Basu P, Bray F and Vaccarella S: Global estimates of incidence and mortality of cervical cancer in 2020: A baseline analysis of the WHO global cervical cancer elimination initiative. Lancet Glob Health. 11:e197–e206. 2023. View Article : Google Scholar : PubMed/NCBI
2	Li M, Du X, Lu M, Zhang W, Sun Z, Li L, Ye M, Fan W, Jiang S, Liu A, et al: Prevalence characteristics of single and multiple HPV infections in women with cervical cancer and precancerous lesions in Beijing, China. J Med Virol. 91:473–481. 2019. View Article : Google Scholar : PubMed/NCBI
3	Lin S, Gao K, Gu S, You L, Qian S, Tang M, Wang J, Chen K and Jin M: Worldwide trends in cervical cancer incidence and mortality, with predictions for the next 15 years. Cancer. 127:4030–4039. 2021. View Article : Google Scholar : PubMed/NCBI
4	Shami S and Coombs J: Cervical cancer screening guidelines: An update. JAAPA. 34:21–24. 2021. View Article : Google Scholar : PubMed/NCBI
5	Awolude OA, Oyerinde SO, Ayeni AO and Adewole IF: Human papillomavirus-based cervical precancer screening with visual inspection with acetic acid triage to achieve same-day treatments among women living with human immunodeficiency virus infection: test-of-concept study in Ibadan, Nigeria. Pan Afr Med J. 40:482021. View Article : Google Scholar : PubMed/NCBI
6	Zhao H, He Y, Fan B, Wang Y and Wu YM: Human papillomavirus E6E7 mRNA and TERC lncRNA in situ detection in cervical scraped cells and cervical disease progression assessment. Virol J. 19:182022. View Article : Google Scholar : PubMed/NCBI
7	Dong A, Xu B, Wang Z and Miao X: Survival-related DLEU1 is associated with HPV infection status and serves as a biomarker in HPV-infected cervical cancer. Mol Med Rep. 25:772022. View Article : Google Scholar : PubMed/NCBI
8	Lyu Y, Ding L, Gao T, Li Y, Li L, Wang M, Han Y and Wang J: Influencing factors of high-risk human papillomavirus infection and DNA load according to the severity of cervical lesions in female coal mine workers of China. J Cancer. 10:5764–5769. 2019. View Article : Google Scholar : PubMed/NCBI
9	Horn J, Denecke A, Luyten A, Rothe B, Reinecke-Lüthge A, Mikolajczyk R and Petry KU: Reduction of cervical cancer incidence within a primary HPV screening pilot project (WOLPHSCREEN) in Wolfsburg, Germany. Br J Cancer. 120:1015–1022. 2019. View Article : Google Scholar : PubMed/NCBI
10	Jary A, Teguete I, Sidibé Y, Kodio A, Dolo O, Burrel S, Boutolleau D, Beauvais-Remigereau L, Sayon S, Kampo M, et al: Prevalence of cervical HPV infection, sexually transmitted infections and associated antimicrobial resistance in women attending cervical cancer screening in Mali. Int J Infect Dis. 108:610–616. 2021. View Article : Google Scholar : PubMed/NCBI
11	Hu H, Zhao J, Yu W, Zhao J, Wang Z, Jin L, Yu Y, Han L, Wang L, Zhu H and Li F: Human papillomavirus DNA, HPV L1 capsid protein and p16(INK4a) protein as markers to predict cervical lesion progression. Arch Gynecol Obstet. 299:141–149. 2019. View Article : Google Scholar : PubMed/NCBI
12	Bedell SL, Goldstein LS, Goldstein AR and Goldstein AT: Cervical cancer screening: past, present, and future. Sex Med Rev. 8:28–37. 2020. View Article : Google Scholar : PubMed/NCBI
13	Chen L, Dong B, Zhang Q, Mao X, Lin W, Ruan G, Kang Y and Sun P: HR-HPV viral load quality detection provide more accurate prediction for residual lesions after treatment: A prospective cohort study in patients with high-grade squamous lesions or worse. Med Oncol. 37:372020. View Article : Google Scholar : PubMed/NCBI
14	Sargent A, Fletcher S, Bray K, Kitchener HC and Crosbie EJ: Cross-sectional study of HPV testing in self-sampled urine and comparison with matched vaginal and cervical samples in women attending colposcopy for the management of abnormal cervical screening. BMJ Open. 9:e0253882019. View Article : Google Scholar : PubMed/NCBI
15	Okunade KS: Human papillomavirus and cervical cancer. J Obstet Gynaecol. 40:602–608. 2020. View Article : Google Scholar : PubMed/NCBI
16	Hernández-López R, Lorincz AT, Torres-Ibarra L, Reuter C, Scibior-Bentkowska D, Warman R, Nedjai B, Mendiola-Pastrana I, León-Maldonado L, Rivera-Paredez B, et al: Methylation estimates the risk of precancer in HPV-infected women with discrepant results between cytology and HPV16/18 genotyping. Clin Epigenetics. 11:1402019. View Article : Google Scholar : PubMed/NCBI
17	Santesso N, Mustafa RA, Schünemann HJ, Arbyn M, Blumenthal PD, Cain J, Chirenje M, Denny L, De Vuyst H, Eckert LO, et al: World health organization guidelines for treatment of cervical intraepithelial neoplasia 2–3 and screen-and-treat strategies to prevent cervical cancer. Int J Gynaecol Obstet. 132:252–258. 2016. View Article : Google Scholar : PubMed/NCBI
18	Zehua W: Obstetrics and gynecology (5th edition). Obstetrics Gynecol. (5th Edition). 2004.
19	Perkins RB, Guido RS, Castle PE, Chelmow D, Einstein MH, Garcia F, Huh WK, Kim JJ, Moscicki AB, Nayar R, et al: 2019 ASCCP risk-based management consensus guidelines for abnormal cervical cancer screening tests and cancer precursors. J Low Genit Tract Dis. 24:102–131. 2020. View Article : Google Scholar : PubMed/NCBI
20	Zhou Y: Investigation of the clinical application value of HR-HPV DNA combined with liquid based cytology in colposcopy of cervical cancer. Contrast Media Mol Imaging. 2022:50545072022. View Article : Google Scholar : PubMed/NCBI
21	Abdel Aziz MT, Abdel Aziz MZ, Atta HM, Shaker OG, Abdel Fattah MM, Mohsen GA, Ahmed HH and El Derwi DA: Screening for human papillomavirus (HPV) in Egyptian women by the second-generation hybrid capture (HC II) test. Med Sci Monit. 12:MT43–MT49. 2006.PubMed/NCBI
22	Poljak M, Marin IJ, Seme K, Brinovec V, Maticic M, Meglic-Volkar J, Lesnicar G and Vince A: Second-generation Hybrid capture test and Amplicor monitor test generate highly correlated hepatitis B virus DNA levels. J Virol Methods. 97:165–169. 2001. View Article : Google Scholar : PubMed/NCBI
23	Knoepp SM, Kuebler DL and Wilbur DC: Resolution of equivocal results with the Hybrid Capture II high-risk HPV DNA test: A cytologic/histologic review of 191 cases. Diagn Mol Pathol. 16:125–129. 2007. View Article : Google Scholar : PubMed/NCBI
24	Burness JV, Schroeder JM and Warren JB: Cervical colposcopy: Indications and risk assessment. Am Fam Physician. 102:39–48. 2020.PubMed/NCBI
25	Zhou Q, Zhang F, Sui L, Zhang H, Lin L and Li Y: Application of 2011 international federation for cervical pathology and colposcopy terminology on the detection of vaginal intraepithelial neoplasia. Cancer Manag Res. 12:5987–5995. 2020. View Article : Google Scholar : PubMed/NCBI
26	Kudela E, Laucekova Z, Nachajova M, Visnovsky J, Bielik T, Krivus S, Biringer K, Balharek T and Zubor P: Colposcopic scoring indexes in the evaluation of cervical lesions with the cytological result of atypical squamous cells, cannot exclude high-grade lesion. J Obstet Gynaecol Res. 46:314–319. 2020. View Article : Google Scholar : PubMed/NCBI
27	McCluggage WG, Judge MJ, Alvarado-Cabrero I, Duggan MA, Horn LC, Hui P, Ordi J, Otis CN, Park KJ, Plante M, et al: Data set for the reporting of carcinomas of the cervix: Recommendations from the international collaboration on cancer reporting (ICCR). Int J Gynecol Pathol. 37:205–228. 2018. View Article : Google Scholar : PubMed/NCBI
28	Zhao X, Song S, Wang Y, Mu X and Zhang L: Effects of photodynamic therapy in the treatment of high-grade vaginal intraepithelial lesions following hysterectomy and HPV infection. Photodiagnosis Photodyn Ther. 42:1033362023. View Article : Google Scholar : PubMed/NCBI
29	Li Y, Lu F and Yin Y: Applying logistic LASSO regression for the diagnosis of atypical Crohn's disease. Sci Rep. 12:113402022. View Article : Google Scholar : PubMed/NCBI
30	Rajaram S and Gupta B: Screening for cervical cancer: Choices & dilemmas. Indian J Med Res. 154:210–220. 2021.PubMed/NCBI
31	Ping W: Application value of HPV test in cervical cancer screening of rural women. J Community Med. 14:22016.
32	Rohner E, Edelman C, Sanusi B, Schmitt JW, Baker A, Chesko K, Faherty B, Gregory SM, Romocki LS, Sivaraman V, et al: Extended HPV genotyping to compare HPV type distribution in self- and provider-collected samples for cervical cancer screening. Cancer Epidemiol Biomarkers Prev. 29:2651–2661. 2020. View Article : Google Scholar : PubMed/NCBI
33	Jespersen MM, Booth BB and Petersen LK: Can biopsies be omitted after normal colposcopy in women referred with low-grade cervical cytology? A prospective cohort study. BMC Womens Health. 21:3942021. View Article : Google Scholar : PubMed/NCBI
34	Wang J, Du Y, Dong J, Zhou Y, Wang P, Zhang X, Chen Y and He P: Clinical significance of genotyping for human papillomavirus (HPV) 16 18/45 combined with cytology in cervical exfoliated cells in HPV oncogenic mRNA-positive women. Gynecol Oncol. 153:34–40. 2019. View Article : Google Scholar : PubMed/NCBI
35	Zhu XH, Li XM, Zhang WL, Liao MM, Li Y, Wang FF, Shang B, Peng LG, Su YJ, You ZJ, et al: Application of artificial intelligence-assisted diagnosis for cervical liquid-based thin-layer cytology. Zhonghua Bing Li Xue Za Zhi. 50:333–338. 2021.(In Chinese). PubMed/NCBI
36	Wittenborn J, Weikert L, Hangarter B, Stickeler E and Maurer J: The use of micro RNA in the early detection of cervical intraepithelial neoplasia. Carcinogenesis. 41:1781–1789. 2020. View Article : Google Scholar : PubMed/NCBI
37	Zhang SK, Luo XP, Li ZF, Su Z, Xia JC, Hu GY, Zhu YJ, Xie LX, Feng XX, Sun XB, et al: Performance of human papillomavirus typing test in cervical precancer lesions and cervical cancer screening. Zhonghua Zhong Liu Za Zhi. 42:252–256. 2020.(In Chinese). PubMed/NCBI
38	Newman H, Hu J, Li X, He J, Bradford L, Shan S, Wu X, Zhu B, Yang W, Fu B, et al: Evaluation of portable colposcopy and human papillomavirus testing for screening of cervical cancer in rural China. Int J Gynecol Cancer. 29:23–27. 2019. View Article : Google Scholar : PubMed/NCBI
39	Cong Q, Song Y, Wang Q, Zhang H, Gao S and Sui L: A retrospective study of cytology, high-risk HPV, and colposcopy results of vaginal intraepithelial neoplasia patients. Biomed Res Int. 2018:58948012018. View Article : Google Scholar : PubMed/NCBI
40	Luo GP, Zeng X, Cao HY, Tang D and Xi MR: The clinical significance of HPV L1/PD-L1 tests combined with colposcopy for cervical precancerous lesions and cervical cancer. Sichuan Da Xue Xue Bao Yi Xue Ban. 52:516–522. 2021.(In Chinese). PubMed/NCBI
41	Liu Y, Liao J, Yi X, Pan Z, Pan J, Sun C, Zhou H and Meng Y: Diagnostic value of colposcopy in patients with cytology-negative and HR-HPV-positive cervical lesions. Arch Gynecol Obstet. 306:1161–1169. 2022. View Article : Google Scholar : PubMed/NCBI
42	Luo Q, Lang L, Han N, Liang L, Shen L and Zhang H: Prevalence and genotype distribution of high-risk human papillomavirus infection among women with cervical cytological abnormalities in Chongqing, China, 2014–2020. Diagn Cytopathol. 49:1237–1243. 2021. View Article : Google Scholar : PubMed/NCBI
43	Painter H, Erlinger A, Simon B, Morroni C, Ramogola-Masire D and Luckett R: Impact of cervicitis on performance of cervical cancer screening using HRHPV testing and visual evaluation in women living with HIV in Botswana. Int J Gynaecol Obstet. 151:144–146. 2020. View Article : Google Scholar : PubMed/NCBI
44	Liu G, Sharma M, Tan N and Barnabas RV: HIV-positive women have higher risk of human papilloma virus infection, precancerous lesions, and cervical cancer. Aids. 32:795–808. 2018. View Article : Google Scholar : PubMed/NCBI
45	Vodicka EL, Chung MH, Zimmermann MR, Kosgei RJ, Lee F, Mugo NR, Okech TC, Sakr SR, Stergachis A, Garrison LP Jr and Babigumira JB: Estimating the costs of HIV clinic integrated versus non-integrated treatment of pre-cancerous cervical lesions and costs of cervical cancer treatment in Kenya. PLoS One. 14:e02173312019. View Article : Google Scholar : PubMed/NCBI
46	Husaiyin S, Han L, Wang L, Ma C, Ainiwaer Z, Rouzi N, Akemujiang M, Simayil H, Aniwa Z, Nurimanguli R and Niyazi M: Factors associated with high-risk HPV infection and cervical cancer screening methods among rural Uyghur women aged >30 years in Xinjiang. BMC Cancer. 18:11622018. View Article : Google Scholar : PubMed/NCBI
47	Garza-Rodríguez ML, Oyervides-Muñoz MA, Pérez-Maya AA, Sánchez-Domínguez CN, Berlanga-Garza A, Antonio-Macedo M, Valdés-Chapa LD, Vidal-Torres D, Vidal-Gutiérrez O, Pérez-Ibave DC and Treviño V: Analysis of HPV integrations in mexican pre-tumoral cervical lesions reveal centromere-enriched breakpoints and abundant unspecific HPV regions. Int J Mol Sci. 22:32422021. View Article : Google Scholar : PubMed/NCBI
48	Dong B, Chen L, Lin W, Su Y, Mao X, Pan D, Ruan G, Xue H, Kang Y and Sun P: Cost-effectiveness and accuracy of cervical cancer screening with a high-risk HPV genotyping assay vs. a nongenotyping assay in China: An observational cohort study. Cancer Cell Int. 20:4212020. View Article : Google Scholar : PubMed/NCBI
49	Ferrera A, Valladares W, Cabrera Y, de la Luz Hernandez M, Darragh T, Baena A, Almonte M and Herrero R: Performance of an HPV 16/18 E6 oncoprotein test for detection of cervical precancer and cancer. Int J Cancer. 145:2042–2050. 2019. View Article : Google Scholar : PubMed/NCBI
50	Suwanthananon C and Inthasorn P: A comparison of the associations of reid colposcopic index and swede score with cervical histology. J Obstet Gynaecol Res. 46:618–624. 2020. View Article : Google Scholar : PubMed/NCBI