{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:30:58Z","timestamp":1786681858632,"version":"build-2736575974"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017712","name":"Bureau of Science and Technology of Ganzhou Municipality","doi-asserted-by":"publisher","award":["GZ2024YLJ188"],"award-info":[{"award-number":["GZ2024YLJ188"]}],"id":[{"id":"10.13039\/100017712","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We compared Liquid-Based Cytologic Test (LCT) results diagnosed as atypical squamous cells\u2013cannot exclude high-grade squamous intraepithelial lesion (ASC-H) with high-risk human papillomavirus (hrHPV) infection status and histopathological findings across two cervical screening groups. Additionally, we analyzed the clinical correlation of ASC-H with cervical lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis included 171,688 cases. LCT specimens were divided into two groups: 31,100 from patients who underwent organized cervical screening with artificial intelligence(AI)-assisted interpretation; and 140,588 from patients who underwent opportunistic screening interpreted manually. Of the 663 cases diagnosed with ASC-H, 387 underwent both HPV testing and subsequent histopathological examination. HPV detection methods included 23-type HPV genotyping, and the Cobas 4800 assay which identifies HPV16\/18 plus 12 other hrHPV subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall prevalence of ASC-H was 0.39%. Among 387 paired cases of ASC-H, the total HPV infection rate reached 84.00%, with hrHPV accounting for 97.82% of cases. Women aged &amp;lt;50 years exhibited more single HPV genotype infections and a significantly higher positivity rate for hrHPV than those aged \u226550 years (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.05). In 297 ASC-H samples tested by HPV23 genotyping, the most prevalent hrHPV genotypes were HPV16 (28.62%), HPV52 (21.89%), and HPV58 (17.17%). Among 90 ASC-H samples detected with Cobas 4800 (HPV16\/18 plus 12 other hrHPV), the infection rates for HPV16, HPV18, and other 12 hrHPV subtypes were 11.11%, 2.22%, and 82.22%, respectively. Histopathological examination confirmed that 137 of the 387 (35.40%) patients with ASC-H had high-grade squamous intraepithelial lesion or worse (HSIL+), with seven HSIL+ lesions testing negative for HPV. Low-grade squamous intraepithelial lesions (LSIL) were identified in 119 cases (30.75%), including 15 that were negative for HPV. There was no significant difference in HSIL+ positivity observed between the two screening groups, whereas the opportunistic screening group showed a significantly higher positivity rate for LSIL compared with the organized cervical screening group (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ASC-H indicates a significant risk of HSIL+, particularly in younger women, regardless of interpretation (AI-assisted or manual). These patients require timely evaluation and suitable treatment, as well as careful follow-up to minimize the risk of missed diagnoses of precancerous lesions and early cervical cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1926183","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:23:11Z","timestamp":1786681391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation between atypical squamous cells\u2013cannot exclude high-grade squamous intraepithelial lesion and cervical lesions: a retrospective analysis of opportunistic and organized cervical screening populations"],"prefix":"10.3389","volume":"16","author":[{"given":"Linhong","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Pathology, Ganzhou Maternal and Child Health Care Hospital","place":["Ganzhou, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Emergency, People\u2019s Hospital of Ganzhou City","place":["Ganzhou, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ganzhou Maternal and Child Health Care Hospital","place":["Ganzhou, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Ganzhou Maternal and Child Health Care Hospital","place":["Ganzhou, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA: A Cancer J For Clin"},{"key":"B2","article-title":"Cancer incidence and mortality across diverse geographical regions in China, 2024","volume":"48","author":"Sun","year":"2026","journal-title":"Chin J Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1672-1535.2004.01.017","article-title":"Cervical cytopathology report method (2001 TBS terminology) and diagnostic. Criteria","volume":"2","author":"Liu","year":"2024","journal-title":"Oncol Prog"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.13283\/j.cnki.xdfckjz.2014.07.020","article-title":"Research progress of cervical cytology ASC-H","volume":"23","author":"Wang","year":"2014","journal-title":"Prog Obstet Gynecol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1002\/cncy.22333","article-title":"Atypical squamous cells of undetermined significance cervical cytology in the Chinese population: Age\u2010stratified reporting rates, high\u2010risk HPV testing, and immediate histologic correlation results","volume":"129","author":"Tao","year":"2020","journal-title":"Cancer Cytopathol"},{"key":"B6","article-title":"China cervical cancer screening guideline (1)","volume":"9","author":"Li","year":"2023","journal-title":"J Compr Tumor Ther (Electron Vers)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11401-8","article-title":"Trends in cervical cancer mortality in China from 1989 to 2018: an age-period-cohort study and Joinpoint analysis","volume":"21","author":"Guo","year":"2021","journal-title":"BMC Public Health"},{"key":"B8","doi-asserted-by":"crossref","DOI":"10.5694\/mja16.00289","article-title":"Impact of the Australian National Cervical Screening Program in women of different ages","volume":"205","author":"Smith","year":"2016","journal-title":"Med J Aust"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000365","article-title":"Cervical cancer screening pilot program in France","volume":"27","author":"Hamers","year":"2018","journal-title":"Eur J Cancer Prev"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics16101541","article-title":"Artificial intelligence in cervical cytology: opportunities and limitations in screening, triage, and diagnostic support","volume":"16","author":"Stanek-Widera","year":"2026","journal-title":"Diagn (Basel)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jasc.2017.07.004","article-title":"ASC-H cytological result: clinical relevance and accuracy of colposcopy in predicting high-grade histological lesions\u2014a 7-year experience of a single institution in Portugal","volume":"6","author":"Marujo","year":"2017","journal-title":"J Am Soc Cytopathol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1002\/cncr.21844","article-title":"Cervical cytology of atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (ASC-H)","volume":"108","author":"Sherman","year":"2006","journal-title":"Cancer"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/cncy.22877","article-title":"Genotype profile of HPV in ASC\u2010H cytology and histologic follow\u2010up\u2014prevalence, distribution, and risk: A retrospective study of 1414 cases","volume":"132","author":"Sun","year":"2024","journal-title":"Cancer Cytopathol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.13898\/j.cnki.issn.1000-2200.2020.10.024","article-title":"Distribution of different subtypes of HPV in patients with high-grade cervical lesions","volume":"45","author":"Xiang","year":"2020","journal-title":"J Bengbu Med Coll"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens13040312","article-title":"FAM19A4 and hsa-miR124\u20132 double methylation as screening for ASC-H- and CIN1 HPV-positive women","volume":"13","author":"Peronace","year":"2024","journal-title":"Pathogens"},{"key":"B16","doi-asserted-by":"crossref","first-page":"102611","DOI":"10.1016\/j.jiph.2024.102611","article-title":"Risk assessment of care HPV testing for the detection of cervical precancerous lesions: 5-year follow-up of a screening program in China","volume":"18","author":"Wang","year":"2025","journal-title":"J Infect Public Health"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.62347\/EVXV1402","article-title":"Analysis of effectiveness in an artificial intelligent film reading system combined with liquid based cytology examination for cervical cancer screening","volume":"16","author":"Liu","year":"2024","journal-title":"Am J Transl Res"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1926183\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T04:23:15Z","timestamp":1786681395000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1926183\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":17,"alternative-id":["10.3389\/fonc.2026.1926183"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1926183","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"article-number":"1926183"}}