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Abstract：
In January 2020, a different cervical cancer screening program started in Germany. Women above the age of 35 are recommended to have a combined HPV and cytology swab every three years. Showing persistent high-risk human papillomavirus (hrHPV), cytologic negative cervical samples at baseline and after 12 months, patients are referred to colposcopy. Entailing considerable additional workload due to the required colposcopies, we analyzed the risk of high-grade cervical intraepithelial neoplasia (CIN 3) in cytologic negative and persistent hrHPV women according to their hrHPV genotypes.Methods In this single center retrospective study, patients with persistent hrHPV, cytology negative cervical samples from our certified Colposcopy Unit in 2020 and 2021 were analyzed. Patient demographics, hrHPV types, biopsy rates and histological reports were collected.Results During the study, 69 patients were enrolled. Most frequent hrHPV genotypes were: hrHPV other 72.5%; HPV 16, 20.3% and HPV 18, 7.2%. Colposcopy showed no or minor changes in 92.7% and major changes in 7.2%. CIN 3 was found in 7 patients (10.1%). Prevalence of CIN 3 by hrHPV genotypes was 27.3% for HPV16, 20.0% for HPV18 and 7.1% for HPVO. A statistically significant dependency between hrHPV and cervical intraepithelial neoplasia was demonstrated (p = 0.048).Conclusion Within this single center study of persistent hrHPV, cytologic negative samples, patients with HPV 16 were more likely to have high-grade disease compared to other hrHPV subtypes. Larger prospective randomized trials are needed to substantiate our results and obtain adjusted cervical cancer screening time intervals according to the hrHPV genotypes.
摘要：
2020年1月，德国开始了另一项宫颈癌筛查计划。建议35岁以上的女性每三年进行一次HPV和细胞学拭子。显示持续性高危型人乳头瘤病毒（hrHPV），基线和12个月后的细胞学阴性宫颈样本，患者被称为阴道镜检查。由于所需的阴道镜检查，带来了相当多的额外工作量，我们根据hrHPV基因型分析了细胞学阴性和持续性hrHPV女性中高级别宫颈上皮内瘤变(CIN3)的风险.方法在这项单中心回顾性研究中，患有持续性hrHPV的患者，分析了我们在2020年和2021年获得认证的阴道镜检查单位的细胞学阴性宫颈样本.患者人口统计学，hrHPV类型，收集活检率和组织学报告。结果在研究期间,共纳入69例患者。最常见的hrHPV基因型为:hrHPV其他72.5%;HPV16,20.3%和HPV18,7.2%。阴道镜检查显示92.7%无变化或有轻微变化，7.2%有重大变化。在7例患者中发现CIN3(10.1%)。hrHPV基因型CIN3的患病率HPV16为27.3%，HPV18为20.0%，HPVO为7.1%。显示了hrHPV和宫颈上皮内瘤变之间的统计学显著依赖性(p=0.048)。结论在这项持续性hrHPV的单中心研究中，细胞学阴性样本，与其他hrHPV亚型相比,HPV16型患者更有可能患高级别疾病.需要更大的前瞻性随机试验来证实我们的结果，并根据hrHPV基因型获得调整的宫颈癌筛查时间间隔。
