Application Value Of Cervical Epithelial Cell FH Test In Cervical Cancer Screening

Background and ObjectiveCervical cancer is currently a malignant tumor with a clear pathogenesis in the world.It mostly occurs in the transitional area of cervical columnar epithelium and squamous epithelium.It is the second most common malignant tumor in women,second only to breast cancer,and is for clinical women.The patient’s physical and mental health poses a great threat.According to the report,cervical epithelia cell-free ferrous ferroproporphyrin(FH)can enter the organelles or cells through the application of relatively fat-soluble substances,and then produce blue precipitates through the oxidation-reduction reaction to cause coloration of uterine epithelial cells,and then determine whether the cells are likely to be malignant according to the coloring status.Looking at the relevant literature,it is pointed out that the sensitivity of FH test is equivalent to that of TCT test,and it has more advantages in practicality,especially for cervical cancer screening of women in economically underdeveloped areas.The specificity of the FH test is lower than that of the TCT test.There is a false positive rate in normal cervical and benign cervical lesions.It is not ruled out that blood mixed in the cervical specimens of the subjects may cause false positives.The feasibility of the FH test method is less used in clinical cervical cancer screening due to the lack of large sample data.This study aims to explore the diagnostic value and practicality of cervical epithelial cell FH testing for cervical lesion screening,and to provide scientific basis for the clinical promotion and application of FH testing in cervical lesion screening under different medical conditions.MethodA total of 10248 cervical cancer screening cases were selected from September 2018 to September 2020 in Maternal and Child Health Hospital of Puyang City.All cases underwent TCT and HPV tests,and the test results met the criteria for referral to colposcopy,and 743 cases underwent cervical biopsy were selected as the study subjects.FH was performed before colposcopy.There were 273 cases of normal or cervical inflammation,195 cases of CINⅠ type,60 cases of CINⅡ type,151 cases of CINⅢ type and 64 cases of cervical cancer confirmed by colposcopy biopsy and pathological examination.Hpv-dna test,TCT test and FH test were performed respectively,and 14 high-risk HPV single infection and multiple infection were recorded in 743 patients.HPV infection was recorded in different pathological findings(inflammation or normal,CINⅠ,CINⅡ,CINⅢ and cervical cancer).TCT detection was recorded for different pathological findings(inflammation or normal,CINⅠ,CINⅡ,CINⅢ and cervical cancer).FH detection was recorded in different pathological findings(inflammation or normal,CINⅠ,CINⅡ,CINⅢ and cervical cancer).Using pathological diagnosis as the gold standard,the coincidence rate,sensitivity,specificity,positive predictive value and negative predictive value of single HPV test,TCT test and FH test for the diagnosis of cervical lesions were recorded.Record the coincidence rate,sensitivity,specificity,positive predictive value and negative predictive value of HPV combined with TCT detection,HPV combined with FH detection and TCT combined with FH detection in the diagnosis of cervical lesions;Record the ROC curve of HPV,TCT and FH in the diagnosis of high-grade cervical squamous epithelial lesions and above.Results(1)Of the 743 patients included in the study,470 were positive for high-risk HPV subtypes,and the total positive rate was 63.26%(470/743),among which HPV16,HPV52,HPV58,HPV33,HPV18,HPV51 Types are the six high-risk HPV subtypes with the highest positive rate.The positive rates are 33.68%,21.26%,18.11%,9.89%,8.84%,and 8.84%.(2)In 273 normal or inflammatory patients,70 were positive for HPV,168 were positive for HPV among 195 patients with CIN Ⅰ,55 were positive for HPV among 60 patients with CINⅡ,and 151 were positive for HPV among 151 patients with CINⅢ.58 of 64 cases of cervical cancer were HPV positive.(3)Pathological diagnosis is regarded as the gold standard.The negative and positive predictive values of HPV detection are 83.90%,85.21%,the coincidence rate is 84.79%,the specificity is 72.53%,and the sensitivity is 91.91%;the negative and positive predictive values of TCT for cervical cancer It is 71.94%,88.45%,coincidence rate is 78.20%,specificity is 81.68%,sensitivity is 81.48%;the negative and positive predictive value of FH test for cervical cancer is 66.13%,77.98%,coincidence rate is 74.02%,specificity It is 60.07%and the sensitivity is 82.13%.In a single test,the HPV test has the highest coincidence rate,sensitivity,and negative predictive value,and the TCT test has the highest specificity and positive predictive value.(4)The negative and positive predictive values of HPV combined with TCT were 94.19%,90.84%,the specificity was 83.15%,and the coincidence rate was 91.92%,which were higher than those of HPV combined with FH and TCT combined with FH,and the difference was statistically significant(P<0.05).The sensitivity of the three groups of detection is close(P>0.05).(5)The area under the ROC curve for HPV,FH and TCT detection is 0.913,0.734,0.701,respectively.Pairwise comparison is that the difference between HPV detection and FH and TCT comparison is statistically significant(P<0.05);there is no statistical difference between FH and TCT comparison Significance(P>0.05).Conclusion(1)The amount of FH precipitated was positively correlated with the degree of nalignancy.The higher the degree of malignancy,the more FH precipitated in the body and the higher the positive rate.(2)FH detection has the advantages of non-invasive,simple and rapid,and the interpretation of the results is simple.FH detection alone has a high sensitivety(>80%),which has a definite clinical potential value in cervical cancer screening.(3)Although FH combined with HPV or FH combined with TCT for cervical cancer screening is not as good as TCT combined with HPV detection,the consistency with pathology is acceptable,which has certain diagnostic value and can be used as a cervical cancer screening method in clinical application.