Diagnostic value of high-risk human papillomavirus viral load on cervical lesion assessment and ASCUS triage

Abstract

This study aims to evaluate HR-HPV viral load in the cervical lesion assessment and its diagnostic value on the triage of ASCUS. The three-step protocol for cervical cancer screening was carried out in 5171 patients from June 2017 to August 2019, and 1620 histopathological results were obtained. The positive rate of HR-HPV and TCT increased with the aggravation of pathological grades of cervical lesions. The sensitivity and specificity of HR-HPV (DH3) to detect CIN II+ were 91.91% and 84.46%, respectively. In comparison, the corresponding results of the cytology test were 80.51% and 83.12%. HPV16/18 viral load was positively correlated with the grade of cervical lesions (p < 0.001, r = 0.321). The diagnostic efficiency of AUC by applying HPV16/18 viral load was 0.682 for the diagnosis of CIN II+. The optimal HPV16/18 viral load for predicting CIN II+ was 6.80 RLU/CO (relative light units/cut-off), with corresponding sensitivity of 48.6%, specificity of 79.7%, and Youden index of 0.283. In the ASCUS population, viral loads were statistically different in HPV16/18 and the other 12 HR-HPV when compared cervicitis group with CIN I group and CIN II+ group (all p < 0.05). Statistical differences were detected concerning HPV16/18 viral load, contact bleeding status, and smoking status when compared cervicitis group with CIN I group and CIN II+ group (p < 0.05), with a corresponding odds ratio of 1.004, 1.533, and 5.513, respectively. Our findings suggest that HR-HPV viral load can be regarded as a useful tool to predict the grade of cervical lesions for ASCUS triage. ClinicalTrials.gov ID: NCT03178136.

Keywords: ASCUS; HR-HPV viral load; cervical lesions.