| Objective:To detect the evaluation of the cervical intraepithelial neoplasia (CIN) and cervical cancer screening effect of three ladder method and three ladder method combing HR-HPV tesring,and to analyze their factors,to provid scientific basis for formulating effective measures to improve womens reproductive health level and to lower cervical cancer mortality.Methods:In this study,the datas are from 1062 Patients with Cervical which were diagnosed from January 2010 to December 2010 in clinic in Health care hospital.For women and chindren of Jinan. The specialtraining nurses collected the informations of ages,educations, contraceptive methods,the ages of first sexual intercourse ,the numbers of sexual parters,tobacco addictions, cleaning of personal and sexual parters,and family history of cancer.All Patients were applied cycology technique . We did biopsy under the guidance of co1poscopy and detected HR-HPV for 310 patients who had positive cycology resuls or had negative cycology resuls with suspicious lesions.The Pathology results are the gold standard.Comparate the results of cytology and colposcopy to the Pathology results. Firstly, the 72 patients who have cervical deseases were the cases group,and the 475 patients who have normal cervixes were control group.To analyze the factors of cervical deseases.Secondly 310 patients who did biopsy under the guidance of co1poscopy and detected HR-HPV were research objects ,and we detected the evaluation of the cervical intraepithelial neoplasia (CIN) and cervical cancer screening effect of three ladder method and three ladder method combing HR-HPV tesring.Result:1. The premature ages of first sexual intercourse less than 19 ages, the more than two of sexual parters,the more than three gravidity,cervical erosion , parity and cleaning of sexual parters and tumor family history etc in two groups had significant difference.And drug contraceptions ,parity and cleaning of personal in two groups and smoking had no significant difference. Cervical erosion and ages(μ=0.223),gravidity(μ=0.265),and tumor family history(μ=0.199)had significant correlation(P<0.05)by poisson analysis.And logic regression found:in 95% confidence interval, first sexual intercourse, sexual parters and cervical erosion had significant correlation(P <0.05).2.There were 182 Patients which had positive cycology resuls in 1062 patients . There were 49 corresponding between the colposcopy diagnosis and pathological diagnosis .And the positive detecting rate was 5.48 percente .The compliance rate of colposcopy diagnosis cervical lesions was 68.05 percente which had increased 22.22 percente.The compliance rate of colposcopy diagnosis >=CINII and were 77.36 percente which had increased 28.29 percente. The detection of cervical lesion rate during TCT and eo1poseopy was 66.67 percent and 93.06 percent, so significant difference was in the two methods (P <0.05).3. In 310 patients,the detection rate of ASCUS in HPV positive is 26.56 percent (17/64),and in HPV negative is 1.79 percent (1/56), which have significant difference . The detection of cervical lesion rate during TCT and HR-HPV detecting with TCT was 66.67 percent and 97.22 percente, so significant difference was in the two methods(P<0.05), which had increased 30.5 percente. High risk HPV DNA test the sitivity, specificity, positive forecasting value, negative forecasting value of>=CINII were 92.86,69.69,27.91,97.79 percent,separately TCT checking CINII and III, the said four value division of LSIL were separately 57.14,99.21,62.90,93.14 percent;and the said four values of combination of HPV DNA test union TCT checking were separately 98.21,69.29,42.97,100 percent.Conclusion:1. The high-risk facts of cervical deseases including the premature ages of first sexual intercourse, the too much numbers of sexual parters,too many pregnancience ,cervical erosion, parity and cleaning of sexual parters and family history etc.And first sexual intercourse, sexual parters and cervical erosion had significant correlation .2.TCT systemeanim can increase the detection and compliance rate of cervical deseases . And the positive detecting rate was 5.48 percente and fasle negtive rate was 31.94%. The compliance and detection rate had increased 22.22 percente and 26.39 percente. The compliance and detection rate of >=CINII had increased 28.29 percente and 35.56 percente.3.High - risk HPV DNA test is a effective method for detecting cervical diseases for ASCUS.In persons whose cytology were ASCUS, the patients with HR-HPV positive resuls should check ecolposeopy ,and the patients with HR-HPV negative resuls should TCT follow-up visit.,to reduce risk of fasle negative smear cause.The combination of high-risk HPV DNA test and cytological test increases the the detection rate of cervical deseases .The combination of high-risk HPV DNA test and cytological test increases the sensitivity and negative-predictive value, but it does not increase the specificity.This is a effective methed for lower cervical cancer incidence. |
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