Study Of The Effect Of Liquid-Based Cytologic Test In Cervical Cancer And Endometrial Carcinoma

Objective: To investigate the applicative value and clinical significance of the AutoCyte PREP cytologic test in the diagnosis of cervical cancer and endometrial carcinoma.Methods: AutoCyte PREP cytologic test was performed on 986 patients in ward before surgery. Eighteen cases with normal cytologic results but suspected as cervical cancer or endometrial carcinoma received a second test on the focus in surgery. The smears of 77 cases with abnormal cytologic results and these 18 cases received immunocytochemistry test of VEGF, Survivin, bcl-2 and bax. By contrast to find the coincidence rate between the results of cytologic test and the histopathologic diagnosis, and to find the clinical significance of immunocytochemistry test.Results:1. The results of AutoCyte PREP cytologic test: 986 cases received cytologic test befor surgery. The detection of normal or inflammation was 909 cases. The detection of ASCUS + AGUS, LSILs, HSIL, SCC, dubious adenocarcinoma and adenocarcinoma were 27 cases, 4 cases, 16 cases, 16 cases, 7 cases and 7 cases. The results of the 18 cases mentioned above were 5 cases unsatisfaction, 3 cases SCC and 10 cases adenocarcinoma.2. The results of immunocytochemistry: In the control group, the expression ofVEGF, Survivin, bcl-2 and bax were all negative. In the experimental group, the cases of the positive expression of VEGF, Survivin, bcl-2 and bax were 64 cases, 59 cases, 46 cases and 46 cases.3. The results of the histopathologic diagnosis: Cervical inflammation or normal was 895 cases. Cervical carcinoma in situ, cervical cancer I , II and III stage were 11 cases, 16 cases, 22 cases and 2 cases. The cases of endometrial carcinoma I , II and III stage were 29 cases, 10 cases and 1 cases, respectively.4. The evaluation of the cytologic test by compared with the histopathologic diagnosis: The coincidence rate between the results of cytologic test and the histopathologic diagnosis was 95.03%. The coincidence rate of HSILs, dubious adenocarcinoma and carcinoma was 97.87%. The coincidence rate of LSILs and below it and normal was 94.89%. The positive predictive value of cytologic test for detection of cervical cancer was 92.16%. And it was 65% for detection of endometrial carcinoma.5. The evaluation of the immunocytochemistry by compared with the histopathologic diagnosis: The positive predictive value of VEGF, Survivin, bcl-2 and bax were 62.75%, 62.75%, 50.98% and 54.90% in 51 cases of cervical cancer. The positive predictive value of VEGF, Survivin, bcl-2 and bax were 70%, 60%, 45% and 40% in 40 cases of endometrial carcinoma.6. The relation between cytologic test and immunocytochemistry: The cytologic test united with the expression of bcl-2 and bax can improve the positive predictive value for detection of cervical cancer(is 96.08% and 96.08%). The cytologic test united with the expression of VEGF, Survivin, bcl-2 and bax can improve the positive predictive value for detection of endometrial carcinoma (is 87.5%, 90%, 82.5% and 80%).Conclusion:1. The coincidence rate between the results of AutoCyte PREP cytologic test and the histopathologic diagnosis was 95.03%.2. The positive predictive value of cytologic test for detection of cervicalcancer was remarkly higher than that for detection of endometrial carcinoma.3. The cytologic test united with the immunocytochemistry can improve the positive predictive value for detection of cervical cancer and endometrial carcinoma.