The role of high-risk HPV genotyping in the detection of high-grade intraepithelial neoplasia or cancer in women with negative cytology but positivity for HPV: A hospital-based investigation in northeastern China

Background: The high-risk human papillomavirus (hrHPV) test has a higher sensitivity for the detection of cervical precancerous lesions than cytology can provide. The present study aimed to analyze the prevalence of hrHPV genotypes and evaluate the role of HPV genotyping triage in the detection of high-grade squamous intraepithelial lesions, adenocarcinoma in situ and cervical cancer (HSIL+) in women with negative cytology but hrHPV positivity. Methods: A retrospective study was performed in women who underwent co-screening at the China Medical University-affiliated Shengjing Hospital between 2012 and 2014. Results: Of the 34,587 women, 2,665 women were eligible for analysis with negative cytology and hrHPV positivity. In HSIL+ groups of 204 women, the common genotypes were HPV16, HPV52, HPV58, HPV33, HPV31 and HPV18. The detection rate of histological HSIL+ in women with HPV16 or HPV33 was significantly higher than that in patients with other hrHPV genotypes (P = 0.00, P = 0.03, respectively). The detection rates of histological HSIL+ in women infected with HPV33 or HPV31 had no significantly difference compared to women infected with HPV16 (P = 0.29, P = 0.19, respectively).The odds ratio (OR) for histological HSIL+ in women with HPV16/18/31/33 was higher than that in women with HPV16/18 (4.21 vs. 3.26). The OR for histological HSIL+ was 5.73 in women with HPV16/18/31/33/52/58. The addition of HPV31/33 genotyping to that of HPV16/18 increased the rate of HSIL+ detection from 63.2% to 77.5% (P = 0.002). Moreover, the colposcopy per HSIL+ detection ratio only increased slightly from 7.7 to 8.1. Conclusion: HPV genotyping played an important role in managing women with negative cytology but hrHPV positivity. In northeastern China, the addition of HPV31/33 genotyping to that of HPV16/18 is deemed necessary in triaging women with a positive HPV test.