Significance Of DNA Ploidy Analysis In Screening For Cervical Cancer In Postmenopausal Women

Cervical cancer is the second common malignant tumor in women,and ranking the second place of cervical cancer.With the aging of the Chinese population in recent years,the incidence of cervical cancer in postmenopausal women has increased significantly.Postmenopausal women is likely to comply with cervical screening,due to postmenopausal women’s physiological structure changes,vaginal atrophy and examination pain,making them hard to adapt to cervical examination.Thus,postmenopausal cervical cytology has a higher false negative rate.Therefore,it is necessary to develop effective strategies for screening cervical cancer in postmenopausal women.Aneuploidy is a marker of cancer cells.For cervical cancer patients,aneuploidy exists at all stages of cancer.When using DNA ploidy analysis method to screen cervical samples,the purpose of detecting cervical cancer and precancerous lesions is achieved by detecting aneuploidy of cells.The low cost,low training requirements,high analysis speed and semi-automation of DNA ploidy analysis make it suitable for primary cervical screening in developing countries.The study collected 21758 cases of cervical liquid-based cytology and31557 cases of HPV detection from December 2015 to December 2018.A total of 7695 cases were selected for DNA ploidy analysis.Feulgen staining and automatic image scanning were performed on cervical samples.Multipoint biopsy of cervical canal was performed for patients who were positive for one of the three methods.They were divided into menopausal group and non-menopausal group.By analyzing and comparing the clinical effects of DNA ploidy analysis,liquid-based cytology and HPV testing oncervical cancer screening in postmenopausal women,the characteristics of cervical lesions in postmenopausal women were summarized,and the significance of DNA ploidy analysis for postmenopausal women was expounded.Among 7695 cases of DNA ploidy screening,the positive rate was17.10%(1316/7695),17.33%(212/1223)in postmenopausal women and17.06%(1104/6472)in non-menopausal women.There was no significant difference in the results of DNA ploidy analysis between postmenopausal and premenopausal women(P > 0.05).The positive rate of liquid-based cytology was 6.13%(1334/21758),11.15%(445/3992)in postmenopausal women and 5%(889/17766)in premenopausal women.There were significant statistical differences in LSIL,ACC and SCC grade lesions between postmenopausal and premenopausal women(P < 0.05),but there were no significant statistical differences in cervical lesions among ASCUS,ASC-H,HSIL and AGC(P > 0.05).In 31557 cases of HPV screening,the positive rate was 18.72%(5908/31557),17.97%(1269/7060)in postmenopausal women,and 18.94%(4639/24497)in premenopausal women.There were no significant differences in the overall HPV infection rate,high-risk HPV infection rate,mixed high and low risk HPV infection rate between postmenopausal and in premenopausal women(P<0.05).Among postmenopausal women,the top three infection rates of high-risk HPV genotypes were HPV16(2.71%),HPV52(2.49%)and HPV53(2.28%)respectively,while among in premenopausal women,the top three infection rates of high-risk HPV genotypes were HPV52(3.00%),HPV16(2.58%)and HPV53(2.10%).Both postmenopausal women and in premenopausal women,the infection rate of low-risk HPV genotype is HPV81,2.27% and1.59% respectively.For postmenopausal women,the sensitivity of HPV testing,DNA ploidy analysis and liquid-based cytology were 88.16%(134/152),77.63%(118/152),67.76%(103/152),and the specificity were 69.23%(18/16),73.08%(19/26),76.92%(20/26),respectively.For premenopausal women,HPV testing,DNA ploidy analysis and liquid-based cytology were used to detect uterine lesions.The sensitivity of cervical lesions were 88.36%(448/507),82.84%(420/507),65.48%(332/507),and the specificity were67.97%(87/128),71.09%(91/128)and 75.78%(97/128),respectively.DNA ploidy analysis ranks second in sensitivity and specificity for postmenopausal and premenopausal women.For postmenopausal and premenopausal women,the sensitivity of HPV testing is better than other cervical screening,but the specificity was lower than other screening methods;the specificity of liquid-based cytology is the better than other two screening methods,and the sensitivity was lower than other two screening methods.