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.