INTRODUCTION We found only a few studies that had performed high-risk human papillomavirus (hrHPV) analyses of inadequate ThinPrep™ Papanicolaou (Pap) tests. Therefore, this study aimed to analyze unsatisfactory ThinPrep Pap tests using hrHPV tests. The colposcopic biopsy results of cases with an unsatisfactory ThinPrep Pap test and positive hrHPV results were revealed. METHODS Between January 1, 2018, and October 31, 2022, 965 (3.7%) of 25,958 liquid-based cytology specimens were evaluated as unsatisfactory. Ninety-five (9.8%) of 965 patients were positive for hrHPV. The colposcopic evaluation was performed in 28 (29.4%) of 95 patients, in whom 23 tests were adequate. RESULTS Twenty-three colposcopy biopsy results showed that 17 (73.9%) of 23 patients had benign biopsy results. High-grade squamous intraepithelial lesions were observed in three (13%) of the 23 patients, and low-grade squamous intraepithelial lesions were observed in two (8.6%) of the 23 patients. One of the 23 (4.3%) patients had keratinized squamous cell carcinoma of the cervix diagnosed histologically, although no tumor was visible upon gynecologic examination. CONCLUSION For the management of unsatisfactory Pap tests, The American Society for Colposcopy and Cervical Pathology (ASCCP) recommends repeat cytology within 2-4 months. Evaluation of such patients using hrHPV tests may triage those with squamous intraepithelial lesions, even invasive cervical cancer. More studies with a larger number of cases are needed to analyze the hrHPV status and biopsy follow-up of cases with unsatisfactory cytology.

中文翻译：

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对 ThinPrep™ 宫颈巴氏涂片检查不充分且高风险人乳头瘤病毒检测结果呈阳性的女性进行组织病理学随访。

简介 我们发现只有少数研究对 ThinPrep™ 巴氏 (Pap) 检测不充分进行了高危人乳头瘤病毒 (hrHPV) 分析。因此，本研究旨在使用 hrHPV 检测分析不令人满意的 ThinPrep 巴氏涂片检测。ThinPrep 巴氏涂片检查结果不理想且 hrHPV 结果呈阳性的病例的阴道镜活检结果被公布。方法 2018年1月1日至2022年10月31日期间，25,958份液基细胞学标本中的965份（3.7%）被评估为不合格。965 名患者中有 95 名 (9.8%) hrHPV 呈阳性。95 名患者中的 28 名（29.4%）进行了阴道镜评估，其中 23 项测试是充分的。结果 23例阴道镜活检结果显示，23例患者中17例（73.9%）活检结果为良性。23 例患者中有 3 例（13%）出现高级别鳞状上皮内病变，23 例患者中有 2 例（8.6%）出现低级别鳞状上皮内病变。23 名患者中的 1 名 (4.3%) 经组织学诊断为宫颈角化鳞状细胞癌，但妇科检查未见肿瘤。结论 对于巴氏涂片检查结果不满意的处理，美国阴道镜和宫颈病理学会 (ASCCP) 建议在 2-4 个月内重复进行细胞学检查。使用 hrHPV 检测对此类患者进行评估，可以对患有鳞状上皮内病变、甚至浸润性宫颈癌的患者进行分类。需要更多病例数的研究来分析 hrHPV 状态以及对细胞学结果不满意的病例进行活检随访。