Application of HPV detection and cytology test in cervical lesion screening / 解放军医学杂志

ABSTRACT

Objective To evaluate the high-risk human papillomavirus(HR-HPV)detection and thinprep cell test(TCT)in the diagnosis of cervical lesion by comparison with pathological findings.Methods The data collected from Dec.2004 to Dec.2006 from 690 patients who had undergone HR-HPV detection,TCT and pathology examination with electronic colposcopy in the Department of Obstetrics and Gynecology,General Hospital of PLA were analyzed retraspactively.Results Among the 690 patients,the coincidence between the findings of TCT and pathology was 22.34%(42/188)for low-grade squamous intraepithelial lesion(LSIL),58.33%(56/96)for high-grade squamous intraepithelial lesion(HSIL)and 100%(16/16)for cervical cancer.The number of patients with the cytological diagnosis of abnormal squamous cells(ASC),LSIL,HSIL and cervical cancer was 315,188,96 and 16,respectively.Among them,the positive rate of HR-HPV of ASC,LSIL,HSIL and cervical cancer was 53.96%(170/315),77.12%(134/188),80.21%(77/96)and 100%(16/16),respectively.Pathologic examination through electronic colposcopy revealed the number of patients with the diagnosis of inflammation,CINⅠ/HPV,CINⅡ/CINⅢ and invasive cancer was 425,81,157 and 27,respectively.Among them,the positive rate of HR-HPV in inflammation was 43.29%(184/425),CINⅠ/HPV 74.93%(60/81),CINⅡ/CINⅢ 91.72%(144/157)and invasive cancer 92.5%(25/27).Among the 690 cases,413 were HR-HPV positive,55.45%(229/413)of which showed CINⅠ/HPV or higher.277 cases were HR-HPV negative,and 87.01%(241/277)of which showed inflammation,12.99%(36/277)of which showed CINⅠ/HPV or higher,and 5.42%(15/277)of which showed CINⅡ/CINⅢ and invasive cervical cancer.Among 315 cases with ASC,170 cases were HR-HPV positive,41.76%(71/170)of which showed CINⅠ/HPV or higher,including 69.01%(49/71)CINⅡ/CINⅢ and invasive cervical cancer.145 cases were HR-HPV negative,only 4.83%(7/145)of which was CINⅡ/CINⅢ and invasive cervical cancer,and 90.34%(131/145)of which was inflammation.Conclusion HR-HPV detection and TCT are feasible for cervical lesion screening.Cytology combined HR-HPV test is favorable for shunting management in cervical lesions.