The Clinic Application Of HPV Detection And TCT In Follow-up Of Cervical Cancer After Radiotherapy

Objective: To investigate the clinical application significance of HPV testingand thin prep cytologic test for follow-up visit of cervical cancer after theRadiation therapy treatment.Methods: Specimens of198women with cervical cancer in the GynecologicOncology Department of tumor hospital affiliated Guangxi Medical Universityfrom August2010to August2013were collected for HPV gene classificationanalysis and thin prep cytologic test before the treatments and after theRadiation therapy treatment respectively3,6,9,12,13-24months, andinvestigate the significance value of HPV testing and thin prep cytologic test inmonitoring and inspecting the uncontrolled or recurrent tumor depending on therelation between the changes of detection results and disease evolution.Results: The total positive rate, single infection and multiple infection ratesof HPV before treatments were91.41%,80.11%,19.89%respectively. Thepositive rate of HPV of the squamous carcinoma group was higher than the nonsquamous carcinoma group(P＜0.05), but there was no significant difference inthe multiple infection rate between the two groups(P＞0.05). There were noobvious differences in positive rate and multiple infection rate between different clinical and other pathological parameters(P＞0.05). The abnormal cytologydetection rate before treatments was96.46%; There were no significantdifference in abnormal cytology or carcinoma cell detection rate between thegroups of different clinical and other pathological parameters(P＞0.05). NeitherHPV positive and negative groups nor multiple infectious and single infectiousgroups had dissimilar abnormal cytology detection rate(P＞0.05). The positiverate of HPV fell after the Radiation therapy treatment, and the positive rate of3months after the Radiation therapy treatment was different from that of6months,9months,12months and13-24month(P＜0.005). There was significantdifference in the positive rate of HPV between6months and12months afterradiotherapy too(P＜0.05). In contrast, the positive rate of the others and themultiple infection rate of different follow-up time were similar(P＞0.05). Theproportion of persistent infection of group with multiple infection of HPV washigher than that of group with single infection(P＜0.05). Besides, The positiverate of HPV of cases of local tumor uncontrolled of3months after radiotherapywas higher that of cases of local tumor controlled too(P＜0.05). The biopsyresults of41cases with twice or more consecutive HPV-positive detectionsshowed that56.01%of CIN or more severe lesions can be detected. The totalabnormal cytology detection rate in24months after radiotherapy was23.77%(92/387times). There was significant difference in abnormal cells detection ratebetween3months and13-24months,6months and13-24months afterradiotherapy(P＜0.005). There was correlation between the various benigncervical cytology changes after Radiotherapy and the interval since the end ofradiotherapy(P＜0.05). The cytologic positive rate of cases of local tumoruncontrolled of3months after radiotherapy was similar with that of cases oflocal tumor controlled(P＞0.05). There were31cases with abnormal cytology after radiotherapy had have Local tissue biopsied, and the qualitative ratio ofcytodiagnosis and pathological diagnosis was90.32%. The two test results areall positive in a half of8cases of local recurrence cases with HPV detection andthin prep cytologic test results. Whereas the other cases had Only one positiveresult or both negative results of the two tests.Conclusions: Both HPV testing and cervical liquid based cytology are agood indicator which may be available for monitoring the activity of the diseaseand Predicting recurrence, and the combination of TCT and HPV testing mighthelp to increase the accuracy of judgment.