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. 2025 Jan 20;25(1):28.
doi: 10.1186/s12905-025-03562-0.

Predicting the risk of high-grade precancerous cervical lesions based on high-risk HPV typing in Changsha China

Yaling Xiao #  1   2 , Rangjiao Liu #  3   4 , Shaobo Wang  3 , Yuxiang Wang  3 , Weimin Miao  4 , Meiwei Chen  3 , Xiaowen Liu  1   2 , Yan Chen  1   2 , Yongchun Wen  1   2 , Zhongping Deng  4 , Lizhong Dai  5 , Zenghui Mao  6   7 , Jun He  8   9
Affiliations

Predicting the risk of high-grade precancerous cervical lesions based on high-risk HPV typing in Changsha China

Yaling Xiao et al. BMC Womens Health. .

Abstract

Background: Persistent infection with high-risk human papillomavirus (HPV) is a significant risk factor for cervical cancer. HPV typing and cytology are conducted in women of appropriate age to assess the risk of cervical lesions and to guide the need for further diagnostic procedures such as colposcopy, cervical biopsy, or treatment. This article explores methods to predict the risks of high-grade precancerous cervical lesions based on high-risk HPV typing.

Methods: We conducted a retrospective analysis of HPV typing data from 158,565 women, including 19,707 who underwent ThinPrep cytologic testing (TCT), 7,539 who had colposcopy examinations, and 4,762 who had biopsies. We evaluated the sensitivity, specificity, and risk parameters of high-grade lesions associated with high-risk HPV types.

Results: (1) The overall prevalence of HPV infection was 17.89%, with the most prevalent types being HPV52 (4.44%), HPV58 (2.10%), HPV53 (1.96%), HPV81 (1.85%), HPV42 (1.75%), and HPV16 (1.44%). (2) The sensitivity and specificity of detecting high-grade lesions in TCT, colposcopy, and biopsy, based on high-risk HPV typing, demonstrated a strong linear correlation with the infection rate of each type. (3) HPV16 was confirmed to have a higher risk of CIN2 + in biopsies using a self-defined risk parameter. (4) The top five HPV types with the highest PPVs and pathogenicity risks in biopsies were HPV45, HPV16, HPV58, HPV33, and HPV18.

Conclusion: In Changsha, China, HPV52, HPV58, and HPV53 were the most prevalent and contributed significantly to high-grade lesions. After adjusting for infection rates, a self-defined risk parameter was proposed as a measure of the intrinsic risks of high-grade lesions associated with high-risk HPV types. Focused monitoring of prevalent high-risk HPV types such as HPV45, HPV16, HPV58, HPV33, and HPV18, which show the highest pathogenicity risks, is recommended in our region.

Keywords: Biopsy; Cervical lesions; Colposcopy; HPV typing; Pathogenicity risk; TCT.

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Conflict of interest statement

Declarations. Ethics approval: The studies involving human participants were reviewed and approved by Medical Ethics Committee of Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University (EC-20240308-12). The patients/participants provided their written informed consent to participate in this study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Infection rates of the 23 HPV types in 158,565 cases
Fig. 2
Fig. 2
TCT results of 19,707 cases positive for non-16/18 high-risk HPV typing
Fig. 3
Fig. 3
The sensitivity and specificity of detecting HSIL + by TCT in relation to the prevalence of non-16/18 high-risk types
Fig. 4
Fig. 4
The sensitivity and specificity of detecting high-grade lesions by colposcopy in relation to the prevalence of high-risk types
Fig. 5
Fig. 5
The sensitivity and specificity of detecting CIN2 + by biopsy in relation to the prevalence of high-risk types
Fig. 6
Fig. 6
Pathogenicity risk of high-grade lesions for high-risk HPV types detected by TCT, colposcopy and biopsy
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