The Clinical Application Of ThinPrep Cytology Test,Human Papillomavirus DNA,C-MYC Gene Detection In Cervical Cancer Screening

ObjectiveTo investigate and optimize the clinical application of ThinPrep Cytology Test, Human Papilloma virus DNA, C-MYC Gene Detection in Cervical Cancer Screening.Methods1000outpatients (25-64years old) without the history of Cervical Diseases were randomly selected in the department of gynecology and obstetrics in No.2Xiangya Hospital of Central South University during November2010to February2011. Cell specimens from cervical squamous column junction and cervical tube had TCT、HPV(SPR method) and C-MYC(FISH technique) detection. Three kinds of detection of any positive result underwent colposcopy and cervical biopsy, based on the histopathology as the gold standard to evaluate three methods of cervical screening sensitivity, specificity, Youden index and the coincidence rate. Evaluate the correlation between screening programme and clinical pathological results with tendency x2test.Results1.1,000patients of which TCT abnormal results were148cases, accounting for14.8%; HPV-positive180cases, accounting for18.0%; C-MYC gene amplification in a total of63cases, accounting for0.63%.263cases of any screening positive result underwent routine colposcopy and cervical biopsy, in which162cases of chronic cervicitis (61.6%), CIN Ⅰ44cases(16.7%), CINⅡ25cases(9.5%), CINIII21cases(8.0%),11squamous cervical carcinoma (SCC)(4.2%).2.①The average age of cytological abnormal patients was (38.13±7.30), High-risk age for ASCUS(AGCUS) and LSIL was31-40, for HSIL was41-50, and for SCC was above40.②The average age of patients who had HPV infection was (38.13±7.30), high-risk age for HPV infection was31-40.③The average age of patients who had C-MYC gene amplification was (40.87±7.89)④According to the histopathology, the average age of patients who had CIN I was (35.43±7.31), high-risk age for CIN I was31-41; The average age of patients who had CIN II was (39.52±6.85), high-risk age was31-40. The average age of patients who had CINIII was(38.81±5.87), high-risk age was41-50. The average age of patients who had cervical carcinoma was (48.64±10.30), high-risk age was above50.3. Study for the distribution of HPV genotype shows that infection rate of HPV16was highest (4.2%), followed by HPV52(2.5%) and HPV58(1.8%).4. Based on the histopathology as standard to evaluate ASCUS patients with HPV screening method, x2test shows that comparison difference has statistics significance (x2=5.62, P<0.05)5. By single application of a screening program, TCT had highest sensitivity (79.2%) and Youden index(0.372), C-MYC detection had highest specificity (83.2%); Application of any two programs combined screening, TCT+HPV had highest sensitivity (98.0%), TCT combined with C-MYC detection can make both higher specificity(63.1%) and Youden index(0.492). With the increased CIN level of pathology, the detection rate of the screening program gradually increased (P<0.05).Conclusions1. Cytological abnormal, HPV infection and C-MYC gene amplification was colsely related with cervical carcinoma. In the cervical cancer screening, TCT+C-MYC detection is the best method for screening of cervical carcinoma.2. It is Meaningful for ASCUS (AGCUS) patients with HPV test.