An Abnormal Cervical Cytology Those High-risk Hpv Infection, Real-time Fluorescent Quantitative Pcr In The Detection Of Human Papilloma Virus

Objective:1.To detect the HR-HPV infectious condition in women with abnormal cytology. 2.To evaluate the utility of cervical cytology and HR-HPV testing in the screening of cervical neoplasia.Method: From January 2005 to May 2006 , 949 patients with abnormal, cervical cytology results(≥ASC-US according to the 2001 TBS diagnosis criteria) among 9,344 patients who accepted Liquid-base Cytology Test(LCT) in China-Japan friendship hospital took HR- HPV testing (HC-Ⅱmethod) and underwent colposcopy with tissue studies. To determine the utility of cervical cytology and HR HPV testing in the screening of high grade squamous intraepithelial lesion.Results:1.Among patients with abnormal cytology,the HR-HPV positive rate in ASC,LSIL,HSIL was 40.3% (174/432) , 44.8% (170/310), 89.4% (185/207), respectively;The patients with pathological diagnosis of NILM,CINⅠ,Ⅱ,Ⅲ,and SCC were 332,391,118,101,7 cases,and the HR-HPV positive rate was 17.3%,66.2%,92.4%,97.0%,100%,respectively; Among patients with ASC-US, rate of HSIL in HR-HPV positive group and HR-HPV negtive group was 10.2%,0.8%, respectively.There was significant difference (P＜0.01); The sensitivity of HR-HPV testing for LSIL and HSIL was 0.767,0.947,respectively; In screening HSIL,the sensitivity of cytology (≥ASC-H) and cytology (≥ASC-H) plus HR-HPV testing was 0.925,0.911, and the specificity was 0.510,0.748, respectively.Sensitivity of cytology (≥LSIL) and cytology (≥LSIL) plus HR-HPV in detecting HSIL was 0.898,0.982, respectively, while the specificity was 0.567,0.779.There was statistical difference;Sensitivity of cytology (≥HSIL) and cytology (≥HSIL) plus HR-HPV was 0.690,0.969, and the specificity was 0.930,0.953,respectively.Conclusion 1.The positive rate of HR-HPV increased with the gravity of cervical lesions.2.HR-HPV testing was useful in triage of ASC-US.3.For patients with abnormal cervical cytology ,HR-HPV testing could effectively improve the sensitivity and specificity in detecting HSIL. Objectives: To evaluate the clinical efficacy of Real-time fluorescent quantitative PCR (FQ-PCR) on female loW genital human papillomavirus (HPV) detection.Methods: 600of 4689 women who accepted cervical cancer screening in China-Japan Friendship Hospital during Jun 2005 to Feb 2006 were selected for 8 genotypes of HPV detecting by FQ-PCR, All patients were classified into six groups according to their histological diagnosis : chronic cervicifis, CINI,Ⅱ,Ⅲ, cancer and condyloma acuminate .The 600 women were tested with HC-Ⅱfor 13 types of high-risk HPV at the same time, the accordance of the results was compared; To evaluate the significance of FQ-PCR and HC-Ⅱtesting in screening cervical lesion; According to the copies of HPV DNA, the relationship between viral loads of HPV and cervical lesions was analyzed.Results: The total accordant rate of FQ-PCR and HC-Ⅱon high-risk HPV types detecting was 86.67%. It was 100% in group of cancer. The accordance was good, the Kappa Index were as blow: on general 0.722, in normal group 0.650, CINⅠ0.514, CINⅡ0.583,CINⅢ0.697, condyloma acuminata 0.659. For the detection of high-grades cervical intraepithelial neoplasia, the sensitivity of FQ-PCR and HC-Ⅱwere 0.839,0.887,and the specificity were 0.537,0.521,no significant difference between the two methods(p＜0.05). The viral load of cervical cancer was much higher than that of every grades cervical intraepithelial neoplasia and cervicitis(p＜0.005). The viral load of different grades of cervical intraepithelial neoplasia were significant difference than that of cervicitis (p＜0.005). The viral load of CINⅡand CINⅢwas higher than that of CINⅠ. But there was not significant difference with the viral load of CINⅡand CINⅢ(P＞0.005).Conclusions: FQ-PCR has good accordance with HC-Ⅱfor high risk types of HPV detection; It is't significant difference between the two methods for detection HSIL. Viral loads of HPV-DNA are increasing with severity of eervical'neoplasia.