Analysis of Influencing Factors for Patients With Low-grade Cervical Lesions Features Under Colposcopy Whose Biopsy Pathology Were High-grade Squamous Intraepithelial Lesion or Above
10.3969/j.issn.1009-6604.2025.10.001
- VernacularTitle:阴道镜子宫颈低级别病变特征患者活检病理为高级别鳞状上皮内病变及以上的影响因素分析
- Author:
Hua LI
1
;
Chunfang CHU
1
Author Information
1. 首都医科大学附属北京妇产医院/北京妇幼保健院妇科,北京 100026
- Publication Type:Journal Article
- Keywords:
Colposcopy;
Cervical biopsy;
High-grade squamous intraepithelial lesion
- From:
Chinese Journal of Minimally Invasive Surgery
2025;25(10):577-583
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the related factors of high-grade squamous intraepithelial lesion(HSIL)and squamous cell carcinoma in patients with low-grade lesion features under colposcopy.Methods A total of 639 patients who underwent colposcopy due to abnormal cervical cancer screening and showed low-grade lesion features under colposcopy from February 2021 to June 2022 were included.The median age was35 years old(range,21-78 years old).Colposcopy biopsy pathology confirmed180 cases(28.2%)of HSIL and above,including132 cases(20.7%)of cervical intraepithelial neoplasia grade2(CIN2),47 cases(7.4%)of CIN3,and 1 case(0.2%)of squamous cell carcinoma.Taking the biopsy pathology results of the cervix as the diagnostic standard,univariate and multivariate analyses were conducted on clinical data and colposcopic image features.Results Multivariate analysis showed that age≥40 years old(OR=2.094,95%CI:1.346-3.258,P=0.001),cytology result of low-grade abnormality(OR=0.467,95%CI:0.300-0.727,P<0.001),coexistence of thin acetowhite epithelium,fine punctation and/or fine mosaic under colposcopy(OR=7.922,95%CI:5.036-12.461,P<0.001;OR=7.787,95%CI:3.239-18.724,P<0.001),and lesion involving 2,3 or 4 quadrants(OR=3.152,95%CI:1.865-5.327,P<0.001;OR=4.079,95%CI:2.080-7.996,P<0.001;OR=7.647,95%CI:3.841-15.228,P<0.001)were independent influencing factors for HSIL and above in patients with low-grade lesion features under colposcopy.Among them,cytology result of low-grade abnormality was a protective factor.However,HPV16 positive and cytology result of high-grade abnormality were not independent influencing factors(P>0.05).Conclusions Patients aged≥40 years old,with multi-quadrant involvement,and with the coexistence of 2 to 3 low-grade lesion images under colposcopy have an increased risk of HSIL and above.These patients should undergo adequate biopsy to reduce the risk of missed diagnosis of HSIL and above.For patients with cytology result of low-grade abnormality,biopsy can be reduced.
