关键词: 子宫颈, 普查, 乳头状瘤病毒科, 宫颈上皮内瘤样病变, 风险调节

Abstract: The main mechanism of cervical cancer is closely related to the persistent infection of high risk human papillomavirus (HR-HPV), and HR-HPV tests have become a main means of recognizing cervical lesions. But they have high sensitivity and poor specificity. Therefore, it is crucial to assess the risk of cervical lesions and screen out abnormality from patients with persistent HR-HPV infection. With the in-depth study for mechanism of cervical lesions, several new detection technologies are gradually applied in clinic. HR-HPV load detection can exclude some patients with transient infection. P16/Ki67 detection makes cytological examination more objective. HPV DNA methylation, host cell DNA methylation and miRNA cervical cancer screening not only has relatively high sensitivity and specificity, but also makes self-sampling possible. Immune microenvironment can reflect the degree of lesion and immune status. Meanwhile, these new examination methods provide a good clinical value for the risk prediction of cervical lesions while providing colposcopy triage in patients with HR-HPV. The paper summarizes some new methods of the triage for HPV positive patients, and provides a reference for further examination and risk prediction after HPV positive.

Key words: Cervix uteri, Mass screening, Papillomaviridae, Cervical intraepithelial neoplasia, Risk adjustment