Objective:This study aims to explore the predictive value of p16/Ki-67 in the progression of high-risk HPV-positive patients with negative cytology. Methods:One hundred and sixty-eight high-risk HPV-positive women with negative cytology were enrolled from May 2017 to June 2017 in the Department of Gynecology,the First Affiliated Hospital of Nanjing Medical University. Follow up were conducted for a period of 2 years to analyze the relationship between the progression and p16/Ki-67 dual staining. Results:①Outcome:88 cases(52.4%)had regressed,54 cases(32.1%)persisted,26 cases(15.5%)progressed;②Univariate analysis showed that age of patient,HC2 HPV value and high-risk HPV genotyping were not risk factors of the progression(P>0.05),positive p16/Ki-67 dual staining showed higher rates of progression(P<0.001). Multivariable logistic analysis showed that positive p16/Ki-67 dual staining was related to the progression;③55 cases had positive p16/Ki-67 dual staining,19 cases(34.5%)of them progressed;113 cases had negative p16/Ki - 67 dual staining,7 cases(6.2%)of them progressed. There were significant difference in progression between patients with positive p16/Ki-67 dual staining and patients with negative p16/Ki-67 dual staining(P<0.05). The sensitivity of p16/Ki-67 in prognosis was 73.1%,the specificity was 74.7%,the positive predictive value was 34.5%,the negative predictive value was 93.8%;④High-risk HPV natural changes:152 patients finished the 2-year follow up. The negative conversion ratio at 6,12,18,24 months for women with negative results of p16/Ki-67 dual staining were higher than those with positive results(P<0.05). Conclusion:Positive p16/Ki-67 dual staining result was a risk factor for progression and negative high-risk HPV conversion. P16/Ki-67 dual staining had predictive value for progression and showed good risk stratification for TCT-negative and high-risk HPV-positive women.