TCT and hrHPV analysis of 318 cases with high-grade cervical intraepithelial neoplasia and cervical cancer / 中国肿瘤临床

ABSTRACT

Objective: To identify appropriate ways of applying the current cervical screening methods to minimize the occurrence of missed diagnosis of high-grade cervical intraepithelial neoplasia (CIN2/3) and cervical cancer. Methods: A retrospective analysis was conducted based on the clinical data of 318 patients, who had CIN2/3 or cervical cancer and were treated in Aviation General Hospital Affiliated to China Medical University between June 2014 and August 2018. Among these cases, 296 involved CIN2/3, and 22 involved cervical cancer. All of the patients involved underwent a thinprep cytology test (TCT) and high-risk human papilloma virus (hrHPV) screening, and their age and TCT and hrHPV results were further analyzed. Results: Among the 296 patients diagnosed with CIN2/3, 130 of them (43.92%) were aged between 30 and 39 years, ranking the top among all age groups. Sixty-nine young patients (23.31%) aged between 20 and 29 years were diagnosed with CIN2/3, ranking in the third place. Among all of the 318 cases, the TCT results were positive in 199 cases (62.58%), hrHPV results were positive in 308 cases (96.86%), and there were 313 cases (98.43%, 313/318) wherein both TCT and hrHPV results were positive according to joint screening. The most predominant hrHPV subtypes were 16, 52, 58, 33, 18, and 31. Conclusions: As an increasing number of young women are diagnosed with CIN2/3 and cervical cancer, their screening should not be ignored. Single use of TCT screening leads to more frequent missed diagnosis of high-grade lesions compared with single use of hrHPV screening, while joint use of both screening methods could improve the detection rate. Even if TCT results were negative, it is suggested to conduct a colposcopy for those patients with high-risk subtypes besides hrHPV16 and 18 positivity, and in particular, for patients with hrHPV 52,58,33, and 31 positivity.