Study On The Relationship Between Human Papilloma Virus And Cervical Lesions And In Combination With TCT In The Screening Of Cervical Lesions

Recent studies have shown that cervical intraepithelial neoplasia (cervicalintraepithelial neoplasia, CIN) has a closely relationship to cervical precancerouslesions, the important means of prevention cervical cancer was early detection andtreatment. Human papillomavirus (human papilloma virus, HPV) persistent infectionplays a central role in cervical intraepithelial neoplasia, and it can be a further leadingcause of cervical cancer.The commonly ways of screening method of cervical lesions include liquid basedcytology test, HPV test, colposcopy, cervical histopathological examination, Thesemethods all have the merits of each, but couldn`t check cervical lesions well usingeach method. Therefore, to combine these methods making the screening more quicklyand accurately is importent for further study.Objective:1.Through the analysis of the epidemiological characteristics in the infection ofwomen in Dalian maternity hospital in HPV, we want to have a preliminaryunderstanding of HPV genotype and age distribution of cases, and multiple HPVinfection, in order to provide an epidemiology evidence for the development of HPVvaccine research later;2. To Study the correlation between HPV types and different grades of cervicallesions; 3.To study the clinical application value of TCT and HPV joint detection andcombined detection in the screening of cervical lesions.Methods:7355patients done HPV genotyping and TCT examination in Dalian maternityhospital were selected to analyze the type of HPV and characteristics of agedistribution. Take340cases done with the colposcopy and biopsy as the researchobjects, using the pathological diagnosis as the gold standard, and then contrastiveanalysis was taken to check between cytological test results, the HPV results andpathological results.Results:1. Of the7355patients,1957cases were HPV positive patients, the total infectionrate was26.6%.21types were detected in HPV positive patients, the highest infectionrate of the type is HPV16(16.3%), the lowest incidence of the type is HPV43(0.2%),and the positive rate of high risk types and four was16(16.3%),58(12.9%),18(12.4%),53(10.3%). The infection rate of HPV was highest in the age group of15-19.The detection of high-risk cases accounted for the highest proportion between eachages is35-39age group. HPV infection is mainly single infection, the infection ratewas21.2%, and the multiple infection rate was5.4%.2. Between340cases of different age groups,the lower disease rates are highest in20-24age group (87%),the highest of high disease rate is≥55age groups (58.3%).The infection rate of HPV in cervical lesions was62.6%(213/340),the positive rate ofhigh risk type was40.3%(137/340),and the rate of multiple infection of HPV was31.9%(68/213).The mainly type of high-risk in high grade lesions was HPV16, about42.1%, the other type of high grade lesions is18,58,52,53, the detection rate of highgrade lesion patients in these high-risk type HPV was significantly higher than that inthe inflammation group and low grade lesion group (P<0.05).3. Treat the high grade lesion of pathological results in340patients as positive,low grade lesions as negative, HPV high-risk as positive, low risk as negative, theresults of TCT≥LISL as positive,≤ASC-H as negative. The sensitivity of TCT detection in the diagnosis of cervical lesions:71%, specificity:76.8%, positivepredictive value:58.5%, negative predictive value:85.2%, the misdiagnosis rate:23.2%, rate of missed diagnosis:29%. The sensitivity of HPV detection in thediagnosis of cervical lesions:74.8%, specificity:75.5%, positive predictive value:58.4%, the negative predictive value:86.7%, the rate of misdiagnosis is:24.5%, therate of missed diagnosis:25.2%. TCT combined with HPV types detection anddiagnosis of cervical lesions plan1with TCT positive and (or) HPV positive, bothnegative as negative, sensitivity:97.2%, specificity:13.3%, positive predictive valueand negative predictive value:34%,91.2%, misdiagnosis rate:86.7%, misseddiagnosis rate:2.8%. Plan2treat negative TCT and (or) HPV negative as negative,both positive as positive, the sensitivity is56.1%, specificity:93.1%, the positivepredictive value:78.9%, negative predictive value:82.2%the misdiagnosis rate:6.9%missed diagnosis rate:43.9%.Conclusion:1. The total infection rate of HPV was26.6%,21types are detected, type16infection rate was the highest. Peak Infection age appeared in the period of youth,occurred mainly in the low risk type, and the infection of high-risk HPV got to peak inmiddle age.2. Different age groups have different cervical lesions rate, and the high incidencerate increased accompanied with age increasing. HPV in cervical infection rate ishigher, and with the increase in the severity of the infection rate of HPV, especiallyhigh-risk HPV infection rate increased.3. Joint detection scheme1can obviously improve the sensitivity and negativepredictive value, it can also decrease the rate of missed diagnosis, and screening andruling out negative better than HPV or TCT detection method. Scheme2cansignificantly improve the specificity, positive predictive value, and decrease the rate ofmisdiagnosis, it is better than single detection in suspected cases location.