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ObjectiveTo explore the application value of high-risk HPV-DNA detection combined with TCT in cervical lesion screening and follow-up. MethodsThis study was conducted from February 2019 to February 2021. During this period， 241 subjects who were the patients referred from the primary community hospitals to the center for re-examination of cervical lesions. Of which 80 were patients with cervical intraepithelial neoplasia. Liquid-based cytology （TCT） technology was used to examine the cervical cytological morphology. The second-generation high-throughput sequencing technology and time-of-flight mass spectrometry technology， independently developed by BGI， were used to screen for HPV-DNA typing. At the same time， biopsy sampling was carried out， and the final pathological diagnosis was made. TCT detection and combined HPV-DNA detection were performed on 80 patients to compare the relationship between TCT alone and TCT/HPV-DNA combined test for the diagnosis and prognosis of CIN Ⅱ and CIN Ⅲ. Follow-up was conducted， and the HPV infection and TCT were re-tested. ResultsAmong the 80 cases of cervical intraepithelial neoplasia， 41 cases （51.25%） were between 35 and 44 years old， higher than the other age groups （P<0.001）. Compared with either TCT or HPV-DNA， TCT combined with HPV-DNA had obvious advantages in sensitivity， specificity， positive predictive value， and negative predictive value （P<0.05）. The recurrence rate in CIN Ⅱ and CIN Ⅲ groups was 9.52% and 16.67% respectively after 18 months of the follow-up. ConclusionTCT detection plays a positive role in cervical pre-cancer screening. By combining high-risk HPV-DNA typing and TCT detection， the detection values of sensitivity and specificity are significantly higher， which can improve the accuracy of cervical lesion screening and is of great significance for the follow-up work.
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Objective To explore the clinical value of the third-generation hybrid capture nucleic acid detection technology （DH3） typing detection of human papillomavirus （HPV） combined with thin-prep cytology test （TCT） in screening cervical cancer. Methods A total of1 582 female patients who received HPV and TCT cervical screening in Liuzhou Workers Hospital， Fourth Affiliated Hospital of Guangxi Medical University， from October 2020 to March 2021， were selected for this retrospective analysis. The cervical histopathological diagnosis was used as the gold standard to evaluate the diagnosis accuracies of HPV and TCT test results. Results Among the 1 582 patients， 334 were positive for HPV and 1 248 were negative； 234 were positive for TCT and 1 348 were negative； 180 were positive for histopathological diagnostic and 1 402 were negative. The sensitivity of HPV detection was 100%， the positive predictive value was 53.9%， the specificity was 89.0%， and the negative predictive value was 100.0%. In the HPV typing test， the positive rate for high-risk types 16/18 was 94.8%， and the positive rate for other 12 high-risk types was 73.8%. There was a little difference between TCT test and pathological test， and the detection consistency rate of high-grade squamous intraepithelial lesions and squamous carcinoma was same. Conclusion HPV testing combined with TCT to screen cervical cancer can reduce the misdiagnosis rate by a single test. The classification test is helpful for the hierarchical management of patients， and has a high clinical value for examination triage and grade screening.
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Context: Liquid-based cytology. Aims: Utility of liquid-based cytology (LBC) was compared to conventional smear cytology in ultrasound-guided fine-needle aspirates of abdominal masses. Settings and Design: This was a prospective comparative study conducted in collaboration with surgery and pediatrics surgery departments of our institute. Subjects and Methods: Thirty patients presenting with evidence of abdominal mass were enrolled for the study and underwent fine-needle aspiration cytology. The material was processed for the preparation of conventional smears and residual material was rinsed into cytolyt for LBC by Thin Prep method and into cell block fluid. The smears prepared from both the methods were compared by two independent and experienced pathologists for adequacy, cellularity, architectural pattern, cytoplasmic preservation, nuclear preservation, and background. Results: Cellularity was frequently higher in the conventional smears than on Thin Prep slides (P value = 0.025). Recognition of architecture was better on the conventional smears (P value = 0.001). Cytoplasm was better preserved on the conventional smears (P value = 0.001) but difference in the preservation of nuclear details was not statistically significant on slides prepared from both the techniques. The background of Thin Prep slides is significantly cleaner than direct smears (P value = 0.001). Non epithelial elements such as mucin and neurofibrillary tangles were better preserved on direct smears (P value = 0.001) but diagnostic accuracy of both the methodologies showed no statistically significant difference (P value = 0.226). Conclusions: The Thin Prep technique utilizes expensive equipment and reagents. It also generates certain morphological artefacts in slides with which a cytologist needs to get familiar. When used in isolation, it may not consistently provide any added advantage in the diagnosis of such lesions and should be used as an adjunct to conventional smears. It may be preferred in situations where material has to be transported for processing or is required for ancillary tests.
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Objective · To investigate the relationship between the results of thin prep cytologic test (TCT), high-risk human papillomavirus (Hr-HPV) detection and vaginalintraepithelial neoplasia (VAIN) after hysterectomy. Methods · A retrospective study was conducted of 56 patients with VAIN after hysterectomy. The analysis included TCT and Hr-HPV examination, clinical data and the relationship between Hr-HPV examinenation and histopathological examination of colposcopy. Results · Postoperative follow-up of TCT and Hr-HPV parallel pathological examination showed that 56 patients had vaginal stump lesions, including cervical factor hysterectomy accounted for 5.81% (45/775) and non cervical factor hysterectomy accounted for 0.19% (11/5933). The difference was statistically significant (P=0.000). In 56 cases of patients with vaginal stump lesions, Hr-HPV infection were 40 cases (accounting for 71.43%), uninfected patients were 16 cases (accounting for 28.57%). The Hr-HPV infection rates of cervical hysterectomy and non cervical factor hysterectomy patients were 80.00% (36/45) and 36.36% (4/11) respectively, and the difference was statistically significant (χ2= 6.248, P=0.012). TCT results showed that the incidence of squamous intraepithelial lesions were 42.22% (19/45) and 9.09% (1/11) respectively. Conclusion · The Hr-HPV infection rate and the morbidity of VAIN of the patients undergone hysterectomy due to the cervical lesionfactors is higher than those who had none cervical lesion factors. In order to identify VAIN early, patients who have the history of hysterectomy should undergo careful evaluation of cervical and vaginal circumstance before surgery and the routine examinations of TCT and Hr-HPV in the follow-up.
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ObjectiveTo study the clinical application value of screening cervical precancerous lesions of high risk human papillomavirus(HPV) testing combined with thin-prep cell test(TCT) in prevention of cervical intraepithelial neoplasma (CIN) and cervical carcinoma. MethodsSeven hundred and sixty-three women were screened by high risk HPV test, TCT and pathology test of biopsy more. The positive coincident rate with the pathology test positive rate during the three technologies was compared.ResultsHigh risk HPV positive was 287 cases, the rate of infection was 37.61％(287/763), and pathology test positive was 82 cases, the coincident rate of which was 28.57％ ( 82/287 ) ; TCT positive was 78 cases, the rate of infection was 10.22％ (78/763), and pathology test positive was 50 cases, the coincident rate of which was 64.10％ (50/78) ; TCT + high risk HPV positive was 59 cases, pathology test positive was 47 cases, and the coincident rate of which was 79.66％ (47/59). Among each coincident rate,the differences were statistically significant (P＜ 0.05). The positive rate of high risk HPV infection CIN I was 32.26％( 10/31 ),CIN Ⅱ 41.38％ (12/29), CIN Ⅲ 93.55％ (29/31), squamous carcinoma of the cervix 96.88％ (31/32),respectively. ConclusionsThe positive rate of high risk HPV increases significantly with the grade of cervical precancerous lesions. It is of great significance to screen in the population for HPV and TCT in a regular time span,since it could not only decrease HPV infection rate and the incidence of cervical lesions,but also prevent the cervical cancer.