Severe cervical inflammation and high-grade squamous intraepithelial lesions: a cross-sectional study

Arch Gynecol Obstet. 2021 Feb;303(2):547-556. doi: 10.1007/s00404-020-05804-y. Epub 2020 Sep 26.


Purpose: Inflammation has been reported as a facilitator in cervical oncogenesis, but the correlation between inflammation and cytological abnormality remains uncertain. The aim of this study was to investigate the correlation between inflammation and cytological abnormality.

Methods: ThinPrep cytological test (TCT) was used to detect cervical cytological abnormalities and inflammation degrees of 46,255 women in this prospective cross-sectional study. Histopathological examination was used to define the cervical intraepithelial neoplasia (CIN) in patients with cervical cytological abnormalities.

Results: The study revealed that 8.87% (4102/46,255) of TCT results had cytological abnormalities. The 4102 included cases were classified as the case group, including atypical squamous cells (ASC), low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL). Women with negative intraepithelial lesion or malignancy (NILM) were classified as the control group. About 88.83% (3644/4102) of women with cytological abnormalities showed inflammations. The rate of severe inflammation was significantly higher in the case group than the control group (23.86% vs. 2.0%, P = 0.000). Our results also showed that patients with severe inflammation had a significantly increasing incidence of cytological abnormality by 12.598 times and elevated the risk of HSIL by 756.47 times, compared to the inflammation negative group.

Conclusion: Severe inflammation was positively related to HSIL. Patients with severe cervical inflammation should be given more follow-ups and regular examinations and treated more carefully than those with mild or no inflammation.

Keywords: Cervical intraepithelial neoplasia; Cytological abnormality; HSIL; Inflammation; TCT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Atypical Squamous Cells of the Cervix / pathology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Inflammation
  • Middle Aged
  • Prospective Studies
  • Squamous Intraepithelial Lesions / pathology*
  • Uterine Cervical Dysplasia / pathology*
  • Uterine Cervical Neoplasms / pathology*
  • Vaginal Smears