The Contrast Research Of Three Joint Screening Strategies For Cervical Cancer

Objective: Through the research of the clinical value of three joint screeningstrategies for cervical cancer, we can provide clinical evidence to reliable and feasiblescreening strategy, and then popularize strategies to different people.Methods:3280women those who were receiving health examination inGynecology Department of Jiangxi Province People’s Hospital, were randomlydivided into three groups: A group(with1100cases)was subjected to TCT combinedwith HPV-DNA genotyping(PCR-reverse dot blot);B group(with1080cases)wassubjected to Pap smear combined with HPV-DNA detection(PCR Fluorescence);Cgroup(with1100cases)was subjected to visual inspection with acetic acid(VIA) andwith Lugol’s iodine(VILI). All of women were assigned to colposcopy, and use thepathological diagnosis as the gold standard. By the comparison of the sensitivity、specificity、positive predictive value and negative predictive value of the three jointscreening strategies to get the result.Result: The sensitivity,specificity,positive predictive value and negativepredictive value,Youden’s index,Kappa were80.9％,98.3％,48.5％,99.6％,0.792,0.567in A group and25％,98％,33.3％,98.5％,0.23,0.239in B groupwhereas73.7％,91.1％,12.7％,99.5％,0.648,0.193in C group for three jointscreening strategies respectively. The difference among the three result of threegroups was statistically significant (P＜0.05): in group A,the index in all items is thehighest; in group B,the level of sensitivity is the lowest; in group C,the level ofpositive predictive value is the lowest.Conclusion: The method of combination of TCT and HPV-DNA genotypingdetection was a better diagnose than the other two ways,so this could be the best wayof cervical cancer screening which is suitable for the developed areas; The method ofcombination of Pap testing and HPV-DNA detecting is suitable for common areasbecause of it’s high accuracy rate; Visual inspection, in the presence of low cost and simplicity of operation, is popularized for the underdeveloped rural areas.