The Study Of HR-HPV On Predicting Cervical High Grade Lesions And Its Pathogenesis

Objective Study the effect of HR-HPV on Predicting Cervical high grade lesions and its pathogenesisMethods Diversion hybrid technology was Used to detect the type of HPV, Roc curve analysis was Used to contrast the diagnostic efficiency of the cervical cytology screening, HPV virus detection and cotesting, SP method was Used to detect the expression of P16INK4a and CK17in different Cervical lesions, correlation analysis was Used to detect the correlation between P16INK4a and CK17and analysis the its effection on high grade lesions.Results1.Divide experimental cases into three groups, named A、B、C.Group A include cases diagnosed as chronic cervicitis and CINI (43cases), Group B include cases diagnosed as CINⅢ and carcinoma in situ (71cases), Group C include cases diagnosed as invisive carcinoma (5cases). The infection rate of HR-HPV in the three groups is46.5%(20/43).83%(59/71).100%(5/5); The infection rate of the group B is higher than the group A. and the difference has statistic meaning (x2=16.85,p<0.05); The total infection rate of patients younger than29years old is80%, the total infection rate of patients older than30years old is72.3%, and the difference don’t have statistic meaning (x2=0.601,p>0.05)2. As ASCUS is Used independently to predict high grade cervical lesions,the sensibility is58.6%,the specificity is31.1%,the positive predictive value is44.7%,the negative value is44.1%,the diagnostic efficiency is44.5%; As HR-HPV virus detection is used independently to predict high grade cervical lesions,the sensibility is73.8%,the specificity is35.4%,the positive predictive value is85.5%,the negative value is46.51%,the diagnostic efficiency is71.4%; As cervical cytological examination whose result is ASCUS combined with HR-HPV virus detection is used to predict high grade cervical lesions.the sensibility is77.6%,the specificity is48.8%,the positive predictive value is73.8%,the negative value is56.4%,the diagnostic efficiency is68%;Roc Curve analysis is used to detect above methods, the CurveArea of HPV Virus detection is0.660, the confidence interval is (0.554-0.767), the Curve Area of Cotesting is0.644, the confidence interval is (0.538-0.750) HR-HPV virus detection and cotesting is better than cervical cytological examination.3.Among the three groups of patients, the expression rate of P16INK4a increases gradually, the case numbers of P16INK4a expressing positively are6(13.95%,45(63.38%),5(100%), the expression rate of CK17decreases gradually,the case numbers of CK17expressing positively are25(58.1%),16(22.5%),0. According the statistic test.the different expressing rates of P16INK4a in the three groups have statistic meaning(x2=32.13, p<0.05), the different expressing rates of CK17in the three groups have statistic meaning(x2=17.78,p<0.05).4.The expression rate of P16INK4a and the infection rate of HPV virus detection are positively correlated (rs=0.291,p<0.005), The expression rate of CK17and the infection rate of HPV virus detection are negetively correlated(rs=-0.335, P<0.005).Conclusion1.The cotesting and HR-HPV virus detecting can be used as the method in predicting high grade lesion, Their diagnosis efficiency is better than cervical cytological examination.2.P16INK4a and CK17may play an important role in the pathogens of HR-HPV infectious resulting in cervical high grade lesion and cervical cancer.