摘要Objective:Our research aims to evaluate the diagnostic accuracy of colposcopy-guided biopsy(CGB)in detecting high-grade cervical lesions and explore how human papilloma virus(HPV)integration status and other factors affect its performance.Methods:A retrospective cohort analysis involving 550 patients was conducted to evaluate whether the HPV integration plays a role in identifying high-grade cervical lesions and cervical cancer.Logistic regression models and area under the curve(AUC)calculations were employed.Results:Our findings revealed that 53.5％of CGB/surgery pairs demonstrated congruent diagnoses,whereas 17.1％showed underestimation and 29.5％overestimation.Furthermore,multivariate logistic regression analysis identified several key predictors for cervical intraepithelial neoplasia(CIN)2+and CIN3+according to surgical pathology.Notably,a CGB confirming CIN2+[odds ratio(OR)=6.0,95％confidence interval(CI):3.9-9.1,P＜0.001],high-grade cytology(OR=2.6,95％CI:1.4-4.9,P=0.003),and HPV integration positivity(OR=2.2,95％CI:1.3-3.5,P＜0.001)emerged as significant factors for CIN2+.Similarly,for CIN3+identification,CGB confirming CIN2+(OR=5.3,95％CI:3.4-8.3,P＜0.001),high-grade cytology(OR=2.6,95％CI:1.5-4.7,P=0.001),and HPV integration positivity(OR=2.0,95％CI:1.3-3.1,P=0.003)were independent predictors.Conclusion:Our study highlights the innovative role of HPV integration testing as a pivotal adjunct to CGB and cytology,offering a comprehensive approach that may enhance the diagnostic precision for high-grade cervical lesions,ultimately achieving more precise management strategies.