We are experienced in screening and diagnosis of cervical squamous intraepithelial patients, but we are at a loss in screening and diagnosis of cervical adenocarcinoma in situ and adenoepithelial lesions, the incidence of which is increasing, or we do not have many ways to deal with them. Recently, we encountered several patients with early adenocarcinoma in situ and high grade adenoepithelial lesions, and after going through the process of screening and diagnosis for them, we slowly realized that the diagnosis of adenoepithelial lesions is not easy indeed. The patient was 31 years old, physical examination found cytology: ASCUS, HPV: 18 positive, no special clinical symptoms, referred to colposcopy. Naked eye observation; no exophytic mass, no obvious bleeding foci. After applying acetic acid solution: an abnormal white area of acetic acid was visible in the area of columnar epithelium at the opening of the cervical canal; iodine did not color it. Biopsy pathology: high-grade glandular intraepithelial lesion (HG-CGIN), positive for P16, with paving stone-like changes. However, the appearance of abnormal images on colposcopy in this patient tends to be slow, and the mucus on the surface must be wiped off first, so that the acetic acid solution can be sufficiently immersed to show the abnormal images, and the patient has already been seen in other hospitals and still has not been detected, probably because of the lack of enough time for colposcopic observation, so that doing colposcopy really requires enough time and patience, and at the same time seeing that he or she is HPV18-positive should be taken into account to be vigilant, so that the lesion can be give the lesion to be detected. The cytology of adenoepithelial lesions can vary widely, and in some cases no abnormalities are found on cytology, especially in patients with lesions deep in the cervical canal, where cytology may not show any abnormal results, or may only show junctional cytologic changes, such as ASCUS, with only HPV positivity. It has been reported that 51% of patients with cervical adenocarcinoma have normal cervical cytology results, and only about 20% of patients with clinically visible lesions have positive smears, and even in patients diagnosed with cervical adenocarcinoma, 27% of cytology results one year ago were normal, and 40% of results three years ago were normal, which demonstrates that it is indeed difficult to achieve the ideal early screening and early diagnosis of adenoepithelial lesions. The cytology of glandular epithelial abnormalities occurs infrequently and is often overlooked by the numerous squamous cells interfering with microscopic observation, while both squamous and glandular cell abnormalities can be present on a single cytologic slide. Cytologic changes in adenocarcinoma in situ often require an experienced cytologist to make a determination. In terms of HPV infection, it has been found that squamous epithelial carcinomas are most often seen with HPV type 16 infection, while adenocarcinomas are most often seen with HPV type 18 infection. Therefore, for those who are positive for HPV type 18, we need to focus on lesions of adenoepithelial origin, and pay attention to the columnar epithelial region and the deeper part of the cervical canal in colposcopic observation as well as to detect the lesions at an early stage. The current colposcopic terminology we use for colposcopy is based on information and experience gained from colposcopic observation of squamous epithelial lesions, and the terminology used to describe them is based on squamous intraepithelial lesions, such as white acetate epithelium, stippled areas, and mosaicism, etc. Glandular intraepithelial lesions are atypical in colposcopic presentation and lack of characteristic changes, and in some cases, even just a couple of thick white rings of the glands or bloody secretions at the opening of the glands. In some cases, even a few thick white rings of the gland, or the appearance of bloody discharge at the opening of the gland is already a severe adenoepithelial lesion. The colposcopic features of adenoepithelial lesions depend on the accumulation of experience and data in the future. Early diagnosis of adenoepithelial lesions requires a combination of cytology, HPV and colposcopy as well as a detailed history, and it is not easy to make an early diagnosis without careful consideration.