The Significance Of Combined Usage Of Cytology And HPV L1Capsid Protein Test In Cervical Cancer Screening

Objective: To evaluate the value of cytology combined use withhuman papillomavirus (HPV) L1capsid protein test in detection of earlycervical dysplasia and to study the expression and clinical significance ofHPV L1capsid protein in ceivical lesions.Methods: During September2009to February2011, a total of325women were screened by combining cytological test (liquid-based ThinPrepcytology test) and HPV L1capsid protein test performed byimmunohistochemical staining, and they were all further biopsied under thecolposcope.Results: Final pathological diagnosis was negative for intraepitheliallesion or malignancy(NILM) in171cases, cervical intraepithelial neoplasia(CIN) I in92cases, CIN II in55cases, CIN III in22cases, invasive cervicalcancer in2cases. Based on the criteria of histology and pathology, thesensitivity, specificity, positive-predictive value and negative-predictivevalue of cytological test for detecting all cases of CIN were77.19%,86.36%,86.27%and77.33%respectively. By HPV L1capsid protein test, thesensitivity, specificity, positive-predictive value and negative-predictive value for detecting all cases of CIN were36.26%,90.26%,80.52%and56.05%respectively. By the combination of cytology and HPV L1capsidprotein test, the sensitivity, specificity, positive-predictive value andnegative-predictive value for detecting all cases of CIN were85.96%,80.52%,84.48%and84.35%respectively. L1capsid protein was positive in47.83%of CIN1,27.27%of CIN2,13.64%of CIN3and0%of SCC.L1expression decreased (P <0.001) with histopathological diagnosisincreasing(P<0.05). By HPV L1capsid protein test, the sensitivity,specificity, positive-predictive value and negative-predictive value fordetecting153cases above atypical squamous cell for undeterminedsignification(ASCUS) of CIN II, III were81.25%,46.07%,52.00%and77.36%respectively.Conclusion: HPV L1capsid protein has an important predict valuefor CIN II, III.It combined with cytology has a higher sensitivity andspecificity,which would be a reliable and effective method for cervicalcancer screening.