Objective: To identify appropriate ways of applying the current cervical screening methods to minimize the occurrence of missed diagnosis of high-grade cervical intraepithelial neoplasia (CIN2/3) and cervical cancer. Methods: A retrospective analysis was conducted based on the clinical data of 318 patients, who had CIN2/3 or cervical cancer and were treated in Aviation General Hospital Affiliated to China Medical University between June 2014 and August 2018. Among these cases, 296 involved CIN2/3, and 22 involved cervical cancer. All of the patients involved underwent a thinprep cytology test (TCT) and high-risk human papilloma virus (hrHPV) screening, and their age and TCT and hrHPV results were further analyzed. Results: Among the 296 patients diagnosed with CIN2/3, 130 of them (43.92%) were aged between 30 and 39 years, ranking the top among all age groups. Sixty-nine young patients (23.31%) aged between 20 and 29 years were diagnosed with CIN2/3, ranking in the third place. Among all of the 318 cases, the TCT results were positive in 199 cases (62.58%), hrHPV results were positive in 308 cases (96.86%), and there were 313 cases (98.43%, 313/318) wherein both TCT and hrHPV results were positive according to joint screening. The most predominant hrHPV subtypes were 16, 52, 58, 33, 18, and 31. Conclusions: As an increasing number of young women are diagnosed with CIN2/3 and cervical cancer, their screening should not be ignored. Single use of TCT screening leads to more frequent missed diagnosis of high-grade lesions compared with single use of hrHPV screening, while joint use of both screening methods could improve the detection rate. Even if TCT results were negative, it is suggested to conduct a colposcopy for those patients with high-risk subtypes besides hrHPV16 and 18 positivity, and in particular, for patients with hrHPV 52,58,33, and 31 positivity.

Objective:To comparative investigate the HPV16 virus-specific immune characteristics of HPV vaccinees, cervical precancerous lesions patients and cervical cancer patients.Methods:Six female HPV vaccinees, five patients with cervical precancerous lesions or cervical cancer and 8 healthy female volunteers from Beijing were recruited as subjects. Peripheral anticoagulated blood specimens were collected from these subjects and the peripheral blood mononuclear cells (PBMCs) and plasma were isolated. After culturing in vitro with the stimulation of L1 protein peptide pool derived from HPV16 for 9-10 days, the percentage of CD4 + and CD8 + -T lymphocytes secreting cytokines IFN-γ, IL-2 and TNF-α in the PBMCs were detected by flow cytometry. The level of HPV16 IgG antibody in plasma was determined by ELISA. Results:The IgG levels of vaccinees were significantly higher than those of healthy donors as well as patients with cervical precancerous lesions or cervical cancer. Moreover, the specific CD4 + T cell immune level of vaccinees against HPV16 was significantly higher than that of healthy controls. Furthermore, there was a positive correlation between the level of specific T cell immunity and the level of antibody against HPV16 in all the donors (Pearson, r>0.4, p<0.05). Conclusions:The virus-specific immune responses, i. e. humoral responses as well as cellular immune responses are presenting diversely among different HPV-related subjects. HPV vaccinees possess robust humoral immunity and CD4 + T cell responses.