The Distribution Of HPV Genetype And Analysis Of TCT United HPV Genetype Testing And HPV16DNA Physical State For Identification Women With Cervical Lesions

Human papillomavirus (HPV) is the primary infectious factorsassociated with malignancy worldwide. HPV infection is the major causativefactor for cervical cancer,a lot of research has been devoted to early screeningof cervical lesions,but facing the problem is that the subjective cytologicalscreening, although HPV testing more objective and sensitive, but with poorspecificity, most HPV infections were transient, only a small part develop tocervical cancer, The integration of HPVDNA into the host genome isconsidered an important event in the progression of premalignant cervicallesions to cervical cancer, whether it can predict the occurrence of cervicalhigh-level intraepithelial neoplasia risk is the purpose of the present study, theaim of our study was to evaluate the epidemiological characteristics ofcervical HPV infection in women of our hospital, to evaluate TCT and HPVgenotyping and combined detection in screening for cervical lesions, and toevaluate the correlation between physical state of HPV and extent of cervicallesion.1Population-Based Study of Human Papillomavirus Infectionand HPVDNA test and Liquid based Cytology test in Screening ofCervical LesionsObjective:1Our aim was to study the prevalence and age distribution of humanpapillomavirus (HPV) infection among patients for cervical lesionscreening, diagnosis and treatment,to understand HPV epidemiologicalcharacteristics, to provide a theoretical basis for the government develop the vaccine’s prevention policy.2To study the value of liquid-based cytology in the screening of cervicallesions.3To Study the value of HPV genotyping in the screening of cervical lesions,and to explore the relationship between HPV genotypes and cervicallesions,study the association between multiple HPV infection and cervicalneoplasia,evaluated the clinical performance of HPV genotyping testsfor use in women with ASCUS cytology results.4To study the value of liquid-based cytology conbined with HPVgenotyping in the prediction and diagnosis of cervical lesions.Methods：The first part, from2009.01until2012.09,7209cases were recruitedinto the study,who were at our hospital gynecology outpatient for cervicallesion screening, diagnosis and treatment, The mean age at baseline was36.3years (SD=9.8, median=36.3, range=16-80),Hybrimax were used to detect21kinds of HPV genotype. The second part:Cervical cell specimens obtainedfrom373women were screened routinely by liquid-based Pap smear. Allspecimens with cellular abnormalities were analyzed subsequently forHPV DNA by HPV genotyping test, which is greater than or equal toASCUS, select248women who were with abnormol cytological results orpositive HR-HPV DNA,Biopsy were done under colposcopy. Pathologicaldiagnosis as the gold standard. The study by the group of cervical lesions levelinflammation,CIN1, CIN2, CIN3, and cervical cancer based on theirhistopathologic diagnosis.Result：1Among7209patients, The overall prevalence of HPV was52.74%（3802／7209）, in addition to HPV43all of21kinds of type were detected,HPV16(18.26%,1316/7209)is the highest prevalence, the lowest rates ofinfection type is HPV43(0.0%) were not detected, the most commonhigh-risk types was HPV-16, and other common high-risk types includedHPV-58, HPV-52, and HPV-18. 2Among7209patients, in which a single genotype rate was34.11%(2459/7209), Multiple-type infections were observed in18.63%(1343/7209)of HPV-positive subjects, The highest percentage was amongwomen aged20-24years and50years older, Age-specific prevalence oflow-risk HPV, high-risk HPV, and overall HPV showed a U-shaped curve.3Sensitivity (SE) of TCT(≥ASC-H) detecing cervical lesions CIN2orhigher sensitivity (SE):57.61%（53/92）, specificity (SP):52.56%（82/156）, positive predictive value (PPV):41.73%（53/127）,negativepredictive value (NPV):67.77%（82/121）,47.44%of the rate ofmisdiagnosis, misdiagnosis rate of42.39%, a positive likelihood ratio of1.21, negative likelihood ratio0.81, OR=1.49.4HPV positive detecing cervical lesions CIN2or higher, sensitivity(SE):83.70%(77/92), specificity (SP):26.92%(42/156), positivepredictive value (PPV):40.31%(77/191), negative predictive value (NPV):73.68%(42/57),16.30%of the rate of misdiagnosis, misdiagnosis rate of73.08%, a positive likelihood ratio of5.13, negative likelihood ratio2.71,OR=1.89.5The Sensitivity (SE) of TCT United the HPV for detecing cervical lesionsCIN2or higher was93.48%(86/92), specificity (SP),12.82%(20/156),positive predictive value (PPV):38.74%(86/222), negative predictivevalue (NPV):76.92%(20/26), the misdiagnosis rate:87.18%, misseddiagnosis rate:6.52%, a positive likelihood ratio (LR+):1.07, negativelikelihood ratio (LR-):0.51, OR=2.10.6The most prevalent HR-HPV types was HPV16of all levels of cervicallesions.Conclusion：Our results show a high prevalence of HPV infection, the HPV totalinfection rate was52.74%.The most prevalent HPV types in our populationwere HPV16,6,58,52,18. Which among the top three of the high-risk typeswere HPV16,58,52. The data presented here may help to inform efforts tointegrate HPV genotyping into cervical cancer screening and to develop vaccination strategies for the high-risk population.The Cytology results ofASCUS patients, histopathologic results could from inflammation tohigh-level cervical intraepithelial lesions, and even cervical cancer.HPV fordiagnosis of CIN2lesions,the sensitivity and negative predictive value werehigher, HPV genotyping test can be used as the triage of women with ASCUScytology during routine cervical cancer screening, to some extent reduce therepeating cytological test,alleviate psychological burden of patients, and tosome extent prevent the loss of the high-risk groups in the follow-up ofwomen with abnormal screening results.HPV detection rate increased withthe level of cervical lesions.Incorporation of HPV testing into the presentPap screening program has the potential of making screening for cervicalcancer more effective, Play an important role in cervical precancerous lesionsand cervical cancer screening. HPV is an important etiological factor forcervical lesions and cervical cancer development, sustained viral infection canlead to high-level cervical intraepithelial neoplasia (CIN) and the occurrenceof cervical cancer.2Analysis of Human papillomavirus type16(HPV16) DNA PhysicalState of Patients with Different grades of CIN and Cervical Cancer andfor Identification of HPV16-infected Women with High-grade Lesionsor Cervical CarcinomaObjective:Persistent infection with a high risk(hr) human papillomavirus(HPV) has been established as the main cause of cervical cancer andhigh-grade cervical intraepithelial neoplasia. Because most infections aretransient, testing for hrHPV lacks specificity and has a low positive predictivevalue. It has been suggested that additional parameters like physical status ofthe viral genome could improve the effectiveness of HPV-based screening.The aim of this study was to evaluate the correlation between physical state ofHPV16infection and extent of cervical lesion, as well as the clinicalsignificance of CIN2or worse. Methods：Select165cases as the research object, For this study, thedatabase was searched for women with a known histologic outcome and aHPV16infection in their clinical history. based on their histopathologicdiagnosis of which The cervicitis18cases, CIN124cases, CIN245cases,CIN351cases and cervical cancer27cases, multiplex PCR for the HPV E2and E6genes, both of which were in the same reaction tube, was performed.PCR products were electrophoresed on a2%agarose gel and stained withGold View. The UV-illuminated gels were photographed with Polaroidnegatives, quantitated with an image scanner and analyzed with IntelligentQuantifier software. The relative ratio of HPV E2to E6PCR products (E2/E6ratio) was calculated.Results：1The single infection ratio of HPV16in normal cervical tissue, cervicalintraepithelial neoplasia (CIN)1, CIN2, CIN3and cervical cancer were38.89%,45.83%,68.89%,62.74%%,85.19%, respectively. single HPVinfection rate is gradually increasing With the increase of cervical lesion level.2The integration ratio of HPV16in normal cervical tissue, cervicalintraepithelial neoplasia (CIN)1, CIN2, CIN3and cervical cancer were16.7%,20.8%,46.7%,62.7%,77.8%, respectively. The discrepancy wasstatistically significant (P <0.05).3The sensitivity (SE) of Diagnosis of cervical lesions by HPV16DNAintegrate state was60.16%, specificity (SP) of79.07%, positive predictivevalue (PPV):90.24%, negative predictive value (NPV):40.96%. Thediagnosis of cervical lesions with high specificity and positive predictivevalue.Conclusion：HPV16E2and E6gene using multiplex PCR and E2/E6ratio can be used as indicators to judge the state of viral integration,Theintegration ratio of HPV16was accompanied by an increase in the grade ofcervical lesion. The integrated state of HPV16infection was stronglyassociated with progression of cervical lesions.