子宫颈病变中p16~(INK4A)蛋白表达及其与HPV16/18感染的关系

目的 探讨p16INK4A 蛋白在子宫颈鳞癌(SCC)和子宫颈上皮内肿瘤(CIN)中的表达及其与HPV16/18感染的关系.方法 用原位杂交法检测HPV16/18在25例子宫颈癌、45例CIN及10例慢性子宫颈炎中的表达,同时用免疫组化EliVision法检测p16INK4A 蛋白的表达.结果 (1)与慢性子宫颈炎相比,CIN Ⅱ级、CIN Ⅲ级、浸润癌HPV16/18杂交信号阳性率显著增高(P<0.01);(2)子宫颈鳞癌组织、CIN Ⅰ级、CIN Ⅱ级、Ⅲ级及慢性子官颈炎标本中p16INK4A 蛋白阳性率分别为100.0%、20.0%、46.7%、100.0%和10.0%;(3)在子宫颈鳞癌及CIN HPV16/18感染的标本中p16INK4A 蛋白表达均是阳性.结论 子宫颈鳞癌的形成与HPV感染、p16INK4A 蛋白过表达是呈正相关关系,p16INK4A蛋白可能作为子宫颈鳞癌及CIN的标志物,对子宫颈癌筛查和预防有重要意义.     

子宫颈癌中Hedgehog信号通路蛋白表达与人乳头状瘤病毒16型感染的关系

目的 探讨Hedgehog(Hh)信号通路蛋白在宫颈癌及其癌前病变中的临床病理学意义,并分析其与人乳头状瘤病毒(HPV)16型感染的关系.方法 32例正常宫颈上皮、71例宫颈上皮内瘤变(CIN;CIN Ⅰ 28例,CIN Ⅱ 18例,CIN Ⅲ25例)和80例宫颈鳞状细胞癌共183例选自延边大学医院、延边妇幼保健院和延边肿瘤医院病理科存档蜡块.应用PCR技术检测上述组织中HPV16型的感染情况,并应用Shh、Ihh、Ptch和Smo 4种Hh信号通路蛋白抗体、组织芯片和免疫组织化学EnVision法检测Hh信号通路蛋白在上述病变组织中的表达情况.结果 Shh、Ihh、Ptch和Smo在正常宫颈黏膜上皮中为弱阳性,而在宫颈癌和CIN Ⅲ中呈强阳性,其表达率均显著高于正常宫颈黏膜上皮(P均<0.05).80例官颈癌标本中HPV16阳性率是77.5%(62/80),而且Shh蛋白的强阳性率在HPV16型阳性的宫颈癌组织中显著高于HPV16阴性组(P<0.05).结论 Hh信号通路蛋白过表达可以作为宫颈癌及其癌前病变的早期辅助诊断指标并有望成为宫颈癌靶向治疗的新靶点,而且Shh蛋白的过表达与HPV16型感染密切相关.     

宫颈癌中α-enolase表达及其与HPV感染的关系

目的探讨烯醇化酶-α(α-enolase)蛋白在宫颈鳞癌中的表达及其与HPV感染的关系。方法应用免疫组化PV-9000两步法检测30例慢性宫颈炎、61例宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和70例宫颈鳞癌组织中α-enolase蛋白的表达,同时应用基因芯片技术检测70例宫颈鳞癌中HPV感染情况。结果 (1)α-enolase蛋白表达于细胞质和(或)胞核中。在慢性宫颈炎、CIN和宫颈癌中,α-enolase蛋白在胞质表达的阳性率分别为4.17%(1/24)、18.5%(10/54)和54.3%(38/70),表达依次增强(P=0.000)。(2)宫颈癌中HPV总感染率为97.1%(68/70),共检出8种HPV基因型,分别为HPV16、18、58、31、52、59、66、68,构成比为80.0%、14.3%、4.3%、4.3%、2.9%、2.9%、1.43%、1.43%。双重感染10例,占14.3%。HPV16、18为主要致病基因型。(3)宫颈癌中α-enolase蛋白表达的定位与HPV16/18感染呈正相关(r=0.340,P=0.012)。结论宫颈鳞癌中α-enolase蛋白表达与HPV16/18感染密切相关,二者在宫颈鳞癌的发生过程中可能起着协同作用。     

宫颈病变程度与人类乳头瘤病毒(16、18型)负荷的关系

目的探讨宫颈病变程度与人类乳头状瘤病毒(HPV)16、18型负荷的关系。方法采用实时荧光定量聚合酶链反应(FQ-PCR)方法,检测宫颈不同病变活检组织及石蜡包埋标本中HPV16、18型感染状况。结果正常宫颈上皮感染HPV16、18型阳性率为3%,CINⅠ、Ⅱ、Ⅲ级和宫颈癌感染HPV16、18阳性率分别为45.7%,69.5%,72.2%和74.6%。正常宫颈与CIN,宫颈癌HPV16、18阳性率差异有极显著性(P<0.0001)。宫颈糜烂(Ⅰ°、Ⅱ°、Ⅲ°),CIN(Ⅰ、Ⅱ、Ⅲ级)及鳞癌HPV16、18阳性标本平均拷贝数分别为:3.58×103、1.80×105、1.19×107,随着病变程度加重而逐渐增加,差异有极显著性(P<0.0001)。结论宫颈病变程度与HPV16、18型负荷呈正相关。对宫颈病变组织标本行HPV16、18型检测,对判断宫颈病变发展趋势,积极处理癌前病变,阻断病程、预防宫颈癌的发生将起到重要作用。     

Relationship between the expression of α-enolase in cervical carcinoma and HPV infection

目的 探讨烯醇化酶-α(α-enolase)蛋白在宫颈鳞癌中的表达及其与HPV感染的关系.方法 应用免疫组化PV-9000两步法检测30例慢性宫颈炎、61例宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)和70例宫颈鳞癌组织中α-enolase蛋白的表达,同时应用基因芯片技术检测70例宫颈鳞癌中HPV感染情况.结果 (1)α-enolase蛋白表达于细胞质和(或)胞核中.在慢性宫颈炎、CIN和宫颈癌中,α-enolase蛋白在胞质表达的阳性率分别为4.17%(1/24)、18.5%(10/54)和54.3%(38/70),表达依次增强(P=0.000).(2)宫颈癌中HPV总感染率为97.1%(68/70),共检出8种HPV基因型,分别为HPV16、18、58、31、52、59、66、68,构成比为80.0%、14.3%、4.3%、4.3%、2.9%、2.9%、1.43%、1.43%.双重感染10例,占14.3%.HPV16、18为主要致病基因型.(3)宫颈癌中α-enolase蛋白表达的定位与HPV16/18感染呈正相关(r=0.340,P=0.012).结论 宫颈鳞癌中α-enolase蛋白表达与HPV16/18感染密切相关,二者在宫颈鳞癌的发生过程中可能起着协同作用.     

宫颈癌组织中Bcl-2、Survivin、CD44v6的表达及其与HPV16/18感染的相关性

目的 研究Bcl-2、Survivin和CD44v6在宫颈癌组织中的表达及其与细胞凋亡、HPV16／18感染的相关性，以探讨宫颈癌的发生机制，指导其诊断预后。方法 采用免疫组化对宫颈组织石蜡标本进行Bcl-2、Survivin、CD44v6的检测，同时采用TUNEL和PCR技术检测细胞凋亡指数（AI）和HPVl6／18感染情况。结果 Bcl-2、Survivin、CD44v6的阳性率和AI在宫颈癌组织中与CIN、正常宫颈组织有差异，且随着临床分期、病理分级的升高阳性率有差异，其表达率与淋巴结转移有关。HPV16／18在正常宫颈组织、CIN和宫颈癌中的阳性率逐渐升高，差异有统计学意义。Bcl-2、Survivin和AI均与HPV16／18感染有相关性。结论 宫颈癌组织中Bcl-2、Survivin、CD44v6的异常表达和HPV16／18感染有关，与宫颈癌的恶变程度有关，可作为宫颈癌筛查预后判断的有利指标。     

P16,Ki67与HPV16/18在宫颈病变中的表达及其临床意义

目的:研究多肿瘤抑制基因P16、细胞核增殖抗原Ki67及高危型人乳头状瘤病毒(high riskhuman papilloma virus,HPV16/18)在宫颈病变中的表达和临床意义。方法:采用免疫组织化学Elivision两步法检测P16和Ki67在宫颈非特异性炎症、宫颈上皮内瘤变(cervical intraepithelialneoplasia,CIN)I级、Ⅱ级和Ⅲ级及宫颈鳞状细胞癌中的表达,用原位杂交法检测HPV16/18的表达。结果:P16蛋白表达在非特异性炎症、CINⅠ级、Ⅱ级和Ⅲ级及宫颈癌中的阳性率分别为20.0%,55.6%,93.6%和100.0%;Ki67蛋白表达在非特异性炎症、CINⅠ级、Ⅱ级、Ⅲ级及宫颈癌中的阳性率分别为17.6%,61.1%,89.4%和100.0%,不同组别间两两比较差异均有统计学意义(P<0.05)。而且P16和Ki67的阳性表达率及染色强度呈递增趋势,表达存在分层现象。HPV16/18在非特异性炎症、CINⅠ级、Ⅱ级、Ⅲ级及宫颈癌中的阳性率分别为30.0%,61.1%,82.9%和100.0%,宫颈病变中HPV16/18的阳性率显著高于非特异性炎症组。结论:P16和Ki67蛋白检测作为宫颈病变的有效的生物学标记,可联合HPV16/18 DNA检测应用于宫颈癌及其癌前病变的筛查和诊断中。     

HeLa及子宫颈癌组织中的DR5和bcl-2表达及其相关性

目的探讨死亡受体DR5、bcl-2蛋白在HeLa细胞株和宫颈癌组织中表达及其相关性。方法采用流式细胞术检测HeLa细胞株细胞表面DR5表达,免疫组化法检测DR5和bcl-2蛋白在HeLa细胞株的表达情况及在76例宫颈癌(包括鳞癌50份,腺癌26份),30例宫颈上皮肉瘤变(CIN)和20例正常宫颈组织中表达,并分析两者的相关性。结果 HeLa细胞株细胞表面DR5表达率30%;DR5和bcl-2蛋白主要在CIN和宫颈癌细胞质表达,DR5蛋白在宫颈鳞癌、腺癌、CIN和正常宫颈组织中阳性表达率分别是66%、62%、40%和35%。鳞癌组织DR5表达高于腺癌,但无统计学意义(P>0.05);宫颈癌组织中DR5的表达量显著强于CIN和正常宫颈组织,差异均有统计学意义(P<0.05),CIN与正常宫颈组织比较,差异无统计学意义(P>0.05)。bcl-2蛋白在宫颈鳞癌、腺癌、CIN和正常宫颈组织的阳性表达率分别为70%、65%、50%和20%。DR5和bcl-2蛋白在宫颈癌组织中的表达呈正相关(χ2=10.75,P=0.000)。结论 DR5和bcl-2蛋白在宫颈癌组织中的表达呈正相关,DR5蛋白表达可能与宫颈癌的发生、发展有一定的关系。     

妇科门诊患者HPV分型检测及结果分析

目的探讨人乳头瘤病毒（human papillomavirus,HPV）的感染在慢性宫颈炎、宫颈上皮内瘤样病变（CIN）及浸润性宫颈癌（ICC）中的表达,旨在提高宫颈上皮内瘤样病变及浸润性宫颈癌的诊断率。方法对就诊的有宫颈疾患的妇女794例,采用导流杂交HPV基因分型技术进行DNA检测。结果 HPV检测阳性113例,阳性率14.23%,其中单一型别HPV感染84例,占总数的74.33%,多型别感染的29例,占总数的25.67%,最常见的HPV基因型为52、16、58、18、53高危型感染率较低危型相比,上升趋势更为明显。结论在宫颈病变筛查中HPV检测可提高细胞学检测的有效性,是早期诊断CINⅢ及ICC的一个重要辅助方法。     

钙激活性中电导钾离子通道在宫颈癌组织中的表达

 目的：观察钙激活性中电导钾离子通道（IKCa1）在宫颈癌组织中的表达变化及其在宫颈癌HeLa细胞凋亡中的作用。方法：应用RT-PCR技术研究18例正常宫颈组织及15例宫颈癌组织中IKCa1 mRNA的表达;利用IKCa1通道的阻断剂----克霉唑处理宫颈癌HeLa细胞,应用RT-PCR技术检测细胞IKCa1 mRNA的表达的变化,MTT法观察细胞增殖抑制的变化。并在倒置相差显微镜、透射电镜下观察HeLa细胞的形态学变化;流式细胞仪检测细胞凋亡率。结果：宫颈癌组织中IKCa1 mRNA的阳性表达率及表达水平（分别为73.33%、1.14±0.45）明显高于正常宫颈组织（分别为11.11%、0.86±0.23）,P<0.05。克霉唑以浓度和时间依赖的方式抑制HeLa细胞的增殖,抑制HeLa细胞的生长,下调IKCa1 mRNA的表达水平,诱导细胞凋亡,并观察到细胞凋亡的形态学改变。 结论：IKCa1的异常表达可能与宫颈癌的发生、发展密切相关,降低其表达可能通过诱导细胞凋亡,从而抑制宫颈癌细胞的增殖。     

实时荧光定量PCR法检测人乳头状瘤病毒的实验研究

目的 通过研究病变宫颈中人乳头状瘤病毒(HPV)16/18型的表达,探讨HPV16/18型病毒感染与宫颈病变发生发展之间的关系.方法 结合病理切片诊断,以免疫组化作对照.运用实时荧光定量PCR技术检测病变宫颈中HPV16/18型DNA拷贝数,以及HPV16/18型E7基因mRNA表达量.结果 慢性宫颈炎患者中HPV16/18型感染率低(7.4%).宫颈管上皮内瘤样变(CIN)组HPV16型感染率较高为69.6%,宫颈癌患者巾为72.7%.HPV16型DNA的拷贝数在宫颈上皮内瘤样变患者中与病理分级没有明显的相关性.但在宫颈癌患者中,病毒DNA的拷贝数明显升高,二者差异明显.CIN轻度(I)、中度(Ⅱ)、高度(Ⅲ)组和宫颈癌患者中,HPV16 E7基冈的表达率分别为0、37.5%、42.9%、63.6%.统计学分析表明,HPV16 E7 mRNA的拷贝数与病情呈明显的正相关性.结论 感染者中主要以HPV16型为主,HPV18型较少.宫颈癌患者中HPV16 DNA拷贝数明显高于CIN Ⅱ、Ⅲ组,HPV16型E7 mRNA在宫颈癌中表达率及表达量明显增加并与宫颈癌变呈正相关.实时荧光定量PCR适合临床宫颈病变病毒的筛查与检测.     

环氧化酶-2及血管内皮生长因子在宫颈癌及其癌前病变中的表达

目的探讨环氧化酶-2（cyclooxygenenase-2,COX-2）的表达与宫颈癌发生的关系以及COX-2与血管内皮生长因子vascular endothelial growth factor,VEGF）表达的关系。方法采用免疫组化（S-P）法检测20例正常宫颈、26例低度宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN;CIN Ⅰ）、28例高度CIN（CIN Ⅱ／Ⅲ）、25例宫颈癌组织中COX-2、血管内皮生长因子vascular endothelial growth faclor,VEGF）的表达,并分析COX-2与VEGF及高危HPV感染的关系。结果在正常宫颈、低度CIN、高度CIN、宫颈癌中COX-2的表达率分别为0、23．08％、57．14％、84％,VEGF的表达率分别为5％、30．77％、60．71％、88％,两者均随着病变的加重表达率明显增加,差异均有统计学意义（P〈0．001）。COX-2表达与VEGF呈显著正相关（P=0．001）。人乳头瘤病毒（HPV）在低度CIN、高度CIN及宫颈癌的感染率分别为30．77％、71．43％、100％,在宫颈癌及其癌前病变中,COX-2与高危HPV感染率呈正相关（P=0．021）。结论COX-2与宫颈癌的发生、发展有关,并可能与肿瘤的血管生成有密切的关系。COX-2可能成为宫颈癌早期防治的靶点。     

Immunohistochemical expression of p16(INK4a) is predictive of HR-HPV infection in cervical low-grade lesions.

The p16(INK4a) is a cyclin-dependent kinase inhibitor that decelerates the cell cycle by inactivating the cyclin-dependent kinases involved in the phosphorylation of the retinoblastoma protein (RB). Expression of E6 and E7 oncogenes of high-risk (HR) human papillomavirus (HPV), affecting the RB-p16 pathway, leads to p16 upregulation. Although it is widely reported that p16 is overexpressed in a high percentage of preneoplastic lesions and in almost all carcinomas of the uterine cervix, protein upregulation and its correlation with HPV infection in low-grade lesions is still being debated. In this study, we investigated in parallel, p16 expression and HPV infection in 100 cervical biopsies (17 normal tissues, 54 CIN1, 10 CIN2, 11 CIN3, eight invasive squamous cancers). Results obtained demonstrated that none of the 17 normal cervical tissues, evaluated by immunohistochemistry, presented p16 positivity whereas, starting from CIN1 (31%) to CIN2 (90%), CIN3 (100%) and carcinomas (100%), a constant and significant increase of protein overexpression (P<0.0001) was observed. In addition, p16 overexpression consistently showed elevated sensitivity (84%) and specificity (98%) in detecting HR-HPV infection with a high positive predictive value (97%) and negative predictive value (86%). Of interest, 93% of the p16-positive CIN1 were also HR-HPV infected. Our findings confirmed that p16 overexpression is associated to high-grade precancerous lesions and cervical carcinomas, and further demonstrated that immunohistochemical evaluation of p16 may be a useful biomarker in identifying HR-HPV-infected low-grade lesions.     

Human papillomavirus genotyping and p16INK4a expression in cervical intraepithelial neoplasia of adolescents.

Adolescents have high rates of human papillomavirus (HPV) infection, and persistent high-risk HPV infection can lead to the development of cervical cancer. The cyclin-dependent kinase inhibitor, p16(INK4a) is overexpressed in cervical intraepithelial neoplasia (CIN), probably due to a persistent and integrated HPV infection. This study investigated p16(INK4a) expression, grades of CIN, and high-risk HPV infection in adolescent cervical biopsies. Biopsies were immunohistochemically stained for p16(INK4a). The presence of wide-spectrum, low-risk, or high-risk HPV was determined by amplifying DNA extracted from the cervical biopsies. Biopsies were classified as cervicitis, 15 cases; CIN 1, 48 cases; CIN 2, 46 cases, and CIN 3, 52 cases. The distribution of p16(INK4a) staining was graded as patchy, diffuse basal, and diffuse full thickness. Pearson's chi(2) tests analyzed the relationships between p16(INK4a) staining, HPV infection, and CIN. Biopsies of cervicitis were negative for HPV and for p16(INK4a) expression. High-risk HPV 16, 18, and 31 increased from 18% in CIN 1 to 66% in CIN 2/3 (P<0.001). In CIN 1, p16(INK4a) was positive in 44% of biopsies with 35% showing patchy, 7% diffuse basal, and one case (2%) showing diffuse full thickness staining. In CIN 2/3, p16(INK4a) was positive in 97% of biopsies with 23% showing patchy, 21% diffuse basal, and 53% diffuse full thickness staining. The difference in the proportions of biopsies showing patchy p16(INK4a) staining in CIN 1 and diffuse full thickness staining in CIN 2/3 was significant (P<0.001). In CIN 1, 61% of high-risk HPV-positive biopsies were p16(INK4a) negative, while all high-risk HPV-positive CIN 2/3 biopsies were p16(INK4a) positive. Diffuse, full thickness p16(INK4a) expression discriminated low-grade from high-grade CIN and appears to be a marker of persistent high-risk HPV infection.     

Human papillomavirus genotyping by oligonucleotide microarray and p16 expression in uterine cervical intraepithelial neoplasm and in invasive carcinoma in Korean women

For evaluating the diagnostic significance of p16(INK4A) over-expression in the uterine cervical intraepithelial neoplasm and in invasive carcinoma, human papillomavirus (HPV) was detected and genotyped by oligonucleotide microarray in archival tissues of 117 cervical specimens, including 47 invasive squamous cell carcinomas (SCC), 30 cases of cervical intraepithelial neoplasia (CIN), 20 adenocarcinomas, and 20 cases of non-neoplastic cervix. The expression of p16(INK4A) protein was immunohistochemically studied in these cases and in five HPV-positive and one HPV-negative cervical cancer cell lines. HPV was detected in 50% of CIN, 61.7% of SCC, and 45.5% of adenocarcinomas. p16(INK4A) expression was seen in all 20 cases of adenocarcinoma, 78.7% (37/47) of SCC, and 96.7% (29/30) of CIN, but not in any cases of the non-neoplastic cervix. There was no difference in p16(INK4A) expression between the HPV-positive and HPV-negative cervical lesions. All HPV-positive and -negative cervical cancer cell lines expressed p16(INK4A) protein. In conclusion, the presence of p16(INK4A) expression in cervical squamous and glandular epithelium indicates the existence of dysplasia or malignancy in the uterine cervix, regardless of HPV infection.     

Evolving immunosuppressive microenvironment during human cervical carcinogenesis

Chronic infection with human papillomavirus (HPV) can result in cervical cancer. To understand how HPV escapes immune eradication, we examined biophenotypes of immune cells in human normal cervix, cervical intraepithelial neoplasia (CIN), and cancer. Expression and cellular localization of Forkhead box protein-3 (FOXP3), indolamine 2,3-dioxygenase (IDO), interleukin (IL)-10, and interferon (IFN)-γ were examined by immunofluorescence and immunohistochemistry. Mean cell densities of stromal FOXP3+ cells, IDO+ cells, IL-10+ cells, CD1a+ cells, and macrophages significantly increased from normal cervix to cancer, whereas densities of IFN-γ+ and MMP-9+ cells increased from normal cervix to CIN but decreased in cancer. Flow cytometry confirmed significant elevation of cervical T cells expressing IFN-γ and transforming growth factor-β in CIN compared with normal cervix. Upon activation, a significantly increased proportion of cervical T cells expressed IFN-γ in CIN than normal. A unique subset of morphologically immature stromal dendritic cells expressing IL-10 and IDO was more numerous in cancer than in normal cervix and CIN. The potentially suppressive immune milieu in the cervix may be permissive of HPV-associated cervical carcinogenesis.     

High-risk HPV detection and concurrent HPV 16 and 18 typing with Abbott RealTime High Risk HPV test

BackgroundHigh-risk human papillomavirus (HPV) is the causative agent of cervical cancer. Among the high-risk types, infection with HPV 16 and 18 is associated with significantly higher risk of disease progression, and consequently these two types together cause approximately 70% of invasive cervical cancer worldwide. Identification of HPV 16 and HPV 18 can provide valuable information for risk stratification and clinical management of patients infected with these two types in both ASC-US triage and primary screening in women over age 30. It may also be valuable in the assessment of HPV vaccine efficacy. Abbott RealTime High Risk (HR) HPV is a recently developed test for the detection of 14 high-risk HPV types with the ability to concurrently identify HPV 16 and 18.ObjectiveTo evaluate the clinical performance of Abbott RealTime HR HPV test. Study design: Abbott RealTime HR HPV was evaluated with 253 cervical specimens obtained from patients with CIN 3 and 340 specimens from patients with cervical cancer to determine clinical sensitivity of the test and the prevalence of types 16 and 18. Additionally, 757 cervical specimens obtained from women 30 years of age or older with normal cytology in a general screening population were tested to determine high-risk HPV positivity rate.ResultsThe Abbott RealTime HR HPV test detected 97.2% (246/253) of CIN 3 specimens and 98.5% (335/340) of cancer specimens. HPV 16 was the most prevalent type in both CIN 3 (72.8%) and cancer specimens (64.5%). HPV 16 and 18 combined were detected in 78.9% of high-risk HPV positive CIN 3 and 84.8% of high-risk HPV positive cancer specimens. In specimens from women 30 years of age or older with normal cytology in a screening population, the HPV positivity rate was 6.5% (49/757).ConclusionsAbbott RealTime HR HPV is a highly sensitive test for detection of high-grade cervical disease and cancer. The HPV 16 and HPV 18 typing capability of the test offers the advantage of stratifying patients at greater risk of progression and may thus aid in better patient care and management.     

Assessment of the effectiveness of HPV16/18 infection referred for colposcopy in cervical cancer screening in Northwest of China

To evaluate the effectiveness of Human papillomavirus16/18 infection referral to colposcopy in cervical cancer screening for women aged 25 years and older in Chinese northwest region Shaan'xi province. A total of 2224 women were diagnosed with primary high‐risk HPV infection by HPV‐DNA genotyping technology during August 2014 to August 2015. A total of 1916 cases referred for colposcopy with histological evidence were enrolled, including 1124 women with HPV16/18 genotype and 792 with other High‐risk human papillomavirus genotypes. A total of 1916 women aged 25 years and older with HR‐HPV positive were referred to colposcopy. The distribution of HPV16, HPV18, and other HR‐HPVs infection were 49.22%, 9.45%, and 41.33%, respectively. 71.56% had normal cervical histology, 7.05% had Cervical Intraepithelial Neoplasia1, 8.82% had CIN2, 7.25% had CIN3, and 5.32% had cervical cancer. The percentage of positivity of HPV16 and HPV18 was highly associated with the relative risk of cervical lesion. The sensitivity and specificity of HPV16/18 for detection of CIN2+ (CIN3+) was 82.68% (92.12%) and 47.87% (46.15%), respectively. The positive predictive value and negative predictive value of HPV16/18 for detection of CIN2+ (CIN3+) was 30.16% (19.75%) and 91.03% (97.60%), respectively. HPV16 and HVP18 are the most common genotypes in high grade cervical lesions in Shaan'xi province. Meanwhile, these two types play predominant roles in the progression of high grade cervical lesion. Primary HPV16/18 detection has high sensitivity and negative predictive value in cervical cancer screening and the strategy for women with HPV16 and HPV18 infection referral to colposcopy is efficient and feasible in northwestern region of China.