2.4 | Colposcopy and histological diagnosis
Colposcopy was performed for all patients with abnormal cytology or AHPV positivity during surveillance by a professional gynaecologist in a colposcopy clinic. A woman underwent combined cervical biopsy with endocervical curettage (ECC) if she presented with one of the following conditions: a high-grade cytology result (HSIL, ASC-H, AGC or AIS), an AHPV-GT-positive result, unsatisfactory colposcopy, or visible lesions. Women with low-grade cytology results (ASC-US or LSIL) and AHPV positivity other than AHPV-GT received a cervical biopsy only. Women with normal cytology/AHPV-negative results did not undergo colposcopy, and their histological diagnoses were considered normal based on ethical grounds. Colposcopists were made aware of the cytology, AHPV and AHPV-GT results before the colposcopy visit was performed. According to the 2014 World Health Organization (WHO) Classification of Tumours of the Female Genital Tract,25 a histological diagnosis was obtained from at least 2 pathologists in the hospital. Immunohistochemical staining for p16INK4A was utilized to adjudicate any CIN2 interpretations.26 If a disagreement with histopathology occurred, then a discussion was held by all pathologists in our hospital until a consensus was reached.