目的 检查 AGC 和广泛的人乳头瘤病毒 (HPV) 基因分型患者发生宫颈上皮内肿瘤 3 级 (CIN3) 病变的相关风险。巴氏 (Pap) 试验中非典型腺细胞 (AGC) 解读的病例与相关广泛的检测一起被确定。 HPV 基因分型和组织学随访结果。在 469,694 例巴氏试验队列中，0.4% 被诊断为 AGC。共有1267例患者同时进行高危型HPV（hrHPV）基因分型，其中40.3%为hrHPV阳性。当 hrHPV 阳性时，组织学随访中宫颈 CIN3 的 AGC 病例百分比为 52.2%，而 hrHPV 结果阴性时为 4.9%。该队列中与宫颈 CIN3 相关的前 5 种 hrHPV 基因型是 HPV16、HPV18、HPV58、HPV52 和 HPV33。事实上，在该队列中发现的 hrHPV 相关 CIN3 病变中，92.8% 的至少一种 HPV 基因型呈阳性。对于前 5 种 hrHPV 基因型（HPV16/18/58/52/33），检测宫颈 CIN3 病变的敏感性为 85.6%，当包括另外 12 种基因型时，检测宫颈 CIN3 病变的敏感性仅增加到 89.0%。 hrHPV 16、18、58、52 和/或 33 型的阳性结果大大增加了患有宫颈 CIN3 病变的可能性。将全面的 HPV 基因分型纳入 AGC 细胞学检查可以实现更精细的风险分层和更量身定制的管理策略。© 作者）2024 年。由牛津大学出版社代表美国临床病理学会出版。版权所有。如需商业重复使用，请联系 reprints@oup.com 获取转载和转载的翻译权。所有其他权限都可以通过我们网站文章页面上的权限链接通过我们的 RightsLink 服务获得 - 如需了解更多信息，请联系journals.permissions@oup.com。

To examine the associated risk of cervical intraepithelial neoplasm grade 3+ (CIN3+) lesions in patients with AGC and extensive human papillomavirus (HPV) genotyping.Cases with atypical glandular cell (AGC) interpretation on a Papanicolaou (Pap) test were identified along with associated extensive HPV genotyping and histologic follow-up results.Within this cohort of 469,694 Pap tests, 0.4% were diagnosed as AGCs. In total, 1267 cases had concurrent high-risk HPV (hrHPV) genotyping, and 40.3% were hrHPV positive. The percentage of AGC cases with cervical CIN3+ on histologic follow-up was 52.2% when hrHPV was positive, whereas it was 4.9% with a negative hrHPV result. The top 5 hrHPV genotypes associated with cervical CIN3+ in this cohort were HPV16, HPV18, HPV58, HPV52, and HPV33. Indeed, 92.8% of the hrHPV-associated CIN3+ lesions identified in this cohort were positive for at least one of these HPV genotypes. The sensitivity of detecting cervical CIN3+ lesions was 85.6% with the top 5 hrHPV genotypes (HPV16/18/58/52/33) and only increased to 89.0% when the additional 12 genotypes were included.In patients with an AGC Pap, the risk of having a cervical CIN3+ lesion is greatly increased by positivity for hrHPV types 16, 18, 58, 52, and/or 33. Incorporating comprehensive HPV genotyping into AGC cytology allows for refined risk stratification and more tailored management strategies.© The Author(s) 2024. Published by Oxford University Press on behalf of American Society for Clinical Pathology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.