Abstract: Objective To evaluate the cervical pathology among high-risk human papillomavirus(HR-HPV)-negative women with atypical squamous cells of undetermined significance(ASCUS) cells and low-grade squamous intraepithelial lesion(LSIL), and to investigate the reasonable management strategies for HR-HPV-negative patients with ASCUS and LSIL. Methods In this retrospective study, 356 cases who visited the Department of Gynecology, Beijing Chaoyang Hospital Affiliated to Capital Medical University during January 1, 2010 to 31 December 2012, and were HR-HPV-negative/ASCUS and LSIL on Pap smear were included; 306 patients were followed up. All the patients were examined by colposcopy and cervical biopsy if necessary. HR-HPV was detected by hybridization assay II, hybird capture Ⅱ(HC-Ⅱ). SPSS18.0 statistical software was used. Results Of the 202 cases, 16(7.9%) and 14 of 154(9.1%) HR-HPV negative ASCUS and LSIL women developed CIN-Ⅲ or worse compared with 32 of 140(22.9%) and 40 of 223(17.9%) HPV-positive ASCUS and LSIL women(P=0.000). The negative predictive value of HR-HPV testing for CIN-Ⅲ or worse in ASCUS and LSIL women were 87.13% and 84.42%, respectively. When cervical pathological data were further evaluated by age groups in HR-HPV-negative women with ASCUS and LSIL, the risk of ≥ CIN-Ⅱ were significantly different in various age groups(P<0.05), the highest group was 30-39 years old patients(18.2%). Conclusion HR-HPV-negative patients with an ASCUS or LSIL Pap test result have a chance of being cervical high grade lesions, 7.9% and 9.1% of HR-HPV-negative patients with ASCUS or LSIL had CIN-Ⅲ or worse, and 14.3% of these patients had CIN-Ⅱ or worse lesions, the negative predictive value of HR-HPV testing for CIN-Ⅲ or worse were lower. Colposcopy should be done for HR-HPV-negative patients with ASCUS or LSIL.

Key words: high-risk human papillomavirus(HR-HPV), atypical squamous cells of undetermined significance(ASCUS), low-grade squamous intraepithelial lesion(LSIL), cervical intraepithelial neoplasia(CIN)