The HPV16/18 Infected CIN Should Be on High Alert Due to LEEP Find Underdiagnosis from Point Biopsy

Abstract Background Cervical cancer is caused by continuous infection of high-risk HPV. The timely and accurate diagnosis could contribute to prevent the damage from cervical cancer to female. Biopsy under the guidance of colposcopy is the gold standard for the diagnosis in cervical cancer which the accuracy is still questionable. We aim to analyze the deficiency and related risk factors of colposcopy guided point biopsy for cervical intraepithelial lesions by comparing the postoperative pathology of LEEP. Methods A retrospective analysis was performed on 1329 patients, they were all tested by HPV genotype with diversion hybrid gene chip technology using 21-type Geno Array Diagnostic Kit, after colposcopic point biopsy and LEEP surgery. All patients were enrolled in group according to the ASCCP 2012 guidelines, and biopsy examination using the German LEISEGANG photoelectronic colposcopy system under the guidance of colposcopy. Results Among all participants, 28.3% (376/1329) and 71.7% (953/1329) were found low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) by colposcopy guided point biopsy, respectively. 20.2% LSIL patients (76/376) were found HSIL after LEEP, and in those 76 new HSIL cases, HPV type 16, type 18, other 12 type (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68) and rest HPV type were found 38.2% (29/76), 14.5% (11/76),43.4% (33/76) and 4.0% (3/76), respectively. In the 953 cases of HSIL diagnosed by colposcopy guided point biopsy (HSIL-PB), 1.6% cases (15/953) were found invasive cancer after LEEP and HPV16/18 infection rate was 86.7% (13/15). Conclusion In this study, we found HPV 16/18 positive patients had a higher risk in misdiagnosis by colposcopic biopsy, especially LSIL cases diagnosed by point biopsy. HPV16/18 infection should be a novel diagnostic biomarker in CIN diagnosis.