INTRODUCTION Primary human papillomavirus (HPV) screening, testing for the virus responsible for 99% of cervical cancers, was introduced in 2018-2020 in the UK. This was preceded by HPV triage of low-grade cytology from 2012. Much of the evidence incorporated into current National Health Service (NHS) colposcopy guidance assessed outcomes prior to this change in screening. The aim of this paper is to assess adherence to NHS cervical screening programme standards, determine the incidence of cases reported as high-risk HPV plus borderline nuclear change in endocervical cells, to calculate colposcopic accuracy and assess histological outcomes in this cohort. METHOD A retrospective audit of women referred to a colposcopy clinic in one NHS trust from 2016 to 2018. Data relating to histological outcomes, cytological follow-up and demographics were collected. RESULTS Of 2001 referrals, 22 data sets identifying HPV-positive borderline endocervical change were eligible for analysis (1.2% incidence). Median age was 29.5. Two-thirds (68.2%, n = 15) had high-grade dysplasia at diagnostic biopsy. Those women with reassuring histology had normal cytological follow-up. Colposcopic accuracy was moderate (positive predictive value 43.8%, negative predictive value 100%). CONCLUSIONS Borderline nuclear change in endocervical cells is an uncommon condition but should be treated as a high-grade referral. All women should be offered a diagnostic biopsy at the initial colposcopy; if no histopathological abnormality is identified, alternative sources of pathology should be considered. Excisional treatment should be recommended to unreliable attenders, those with a complete family and inadequate colposcopy (TZ3) and considered in younger women with a TZ3.

中文翻译：

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对基于液体的细胞学样本进行的审核报告为高风险的人乳头瘤病毒和宫颈内膜细胞的临界核变化。

简介于2018-2020年在英国引入了原代人乳头瘤病毒（HPV）筛查，以检测引起99％宫颈癌的病毒。在此之前，从2012年开始对低级细胞学进行HPV分流。目前纳入国家卫生服务（NHS）阴道镜检查指南的许多证据都在筛查发生这种变化之前评估了结局。本文的目的是评估对NHS子宫颈筛查计划标准的依从性，确定报告为高危HPV的病例的发生率以及子宫颈细胞的临界核变化，以计算阴道镜的准确性并评估该队列的组织学结果。方法从2016年至2018年，对妇女进行的回顾性检查在一个NHS信托中转诊至阴道镜诊所。与组织学结果相关的数据 收集细胞学随访资料和人口统计学资料。结果在2001年的转诊中，有22项确定HPV阳性交界性宫颈管变化的数据符合分析要求（发生率1.2％）。中位年龄是29.5岁。在诊断活检中，三分之二（68.2％，n = 15）患有高度不典型增生。那些组织学令人放心的妇女细胞学随访正常。阴道镜检查的准确性为中等（阳性预测值43.8％，阴性预测值100％）。结论宫颈细胞边界线改变并不常见，但应视为高级转诊。初次阴道镜检查应为所有妇女提供诊断性活检；如果未发现组织病理学异常，则应考虑其他病理来源。不可靠的参加者应建议行消融治疗，