Investigation Of Human Papillomavirus Infection Risk Factors At Cervix Uteri And Comparation Of Cervical Cancer Screening Projects

ObjectivePart1To investigate cervical diseases of married female residents that from age18to65inGuangzhou and the prevalence and relevant high risk factors of human papillomavirus(HPV) infection.Part2(1) To analyse nuclear DNA Ploidy of cervical cast-off cell from1535patients byimage analysis system and compare results of TCT and DNA quantitativeanalysis.(2) To compare accuracy of conventional cytology, DNA quantitative analysis, HPVgenotyping and pair-wise combination for the detection of high-grade cervicalintraepithelial neoplasia according to the criterion of pathohistology diagnosis.MethodsPart1Epidemiology survey of998women in6communities in Tianhe District，Guangzhou,investigation of the high risk of HPV and the basal cell examination ofcervical fluid,and perform the univariate and multivariate analysis of the HPVinfection related factors.Part2To inspect results of TCT and DNA Ploidy analysis in1535cervical cancerscreening patients at The First Affiliated Hospital of Jinan University from June2011to August2012.434patients of that have accepted high risk HPV DNA analysis. Theuncertain cases were required to be deteced biopsy from gynecatoptron in order toassess accuracy of above three methods in predicting high-grade cervical diseases.ResultsPart1In998married female patients, there are123high risk HPV-positive subjects. Total positive rate is12.32%. One factor analysis indicated monthly income, profession and columnar ectopy were riskfactors of HPV infection (P<0.10). Multi-factor analysis indicated non-family women（OR=2.21，P=0.032；95%CI：1.07~4.55）, moderate（OR=1.95,P=0.063；95%CI：0.97~3.93） and severe（OR=6.39, P=0.006；95%CI：1.70~24.01） columnar ectopy were independent risk factors.Part2 There was no significant difference（sχ2=0.20，P=0.888）between ASCUS group andnon-ASCUS group（ASC-H，LSIL，HSIL，AGC）.The sensitiveness and specificityof CIN Ⅱor higher lesion diagnosis was83.33%and60.00%by TCT. Thesensitiveness and specificity of CIN Ⅱo r higher lesion diagnosis was77.78%and36.67%by DNAPloidy analysis. The sensitiveness and specificity of CIN Ⅱor higherlesion diagnosis was91.67%and30.00%by high risk HPV analysis. Thesensitiveness and specificity of CIN Ⅱor higher lesion diagnosis was100.00%and80.00%by TCT and high risk HPV analysis. The sensitiveness and specificity ofCIN Ⅱo r higher lesion diagnosis was83.33%and80.00%byDNA Ploidy analysisand high risk HPV analysis. The sensitiveness and specificity of CIN Ⅱor higherlesion diagnosis was83.33%and70.00%by DNA Ploidy analysis and TCT.ConclusionsPart1The cervical high risk infection rate of female citizen in Guangzhou was12.32%.Independent risk factors that affected HPV infection were non-family women,moderate and severe columnar ectopy.Part2The accuracy of two combinative methods for screening high-grade cervical diseasesis better than single project. That are, which TCT combinated with high risk HPVanalysis or DNA Ploidy analysis combinated with high risk HPV analysis, alleffectively methods for screening high-grade cervical diseases.