The Application Of TCT, HC2and Colposcopy In The Test Of Cervical Lesion

Objective:To inve. ate the value of Thinprep Cytology Test(TCT), Hybrid Capture2(HC2) and colplscopy in the test of cervical lesion.Methods:We collected342patients who had TCT, HC2, colposcopy and colposcopic biopsy from January2013to December2013in clinic of the Tianjin Central Hospital of Gynecolgy Obstetrics cause the cervical screening test abnormal. We evaluate the value of the three test methods to cervical lesion.Results:1. The pathology of139TCT-negative cases included107cases of normal.19cases of CIN1,11cases of CINⅡ,2cases of CINⅢ, none of cervical cancer. The pathology of113ASCUS cases included58cases of normal,11cases of CIN Ⅰ.24cases of CIN Ⅱ,20cases of CINⅢ, none of cervical cancer. The pathology of71LSIL cases included31cases of normal,14cases of CIN Ⅰ,18cases of CIN Ⅱ,7cases of CINIII,1case of cervical cancer. The pathology of19HSIL cases included2cases of normal,2cases of CIN Ⅰ.5cases of CIN Ⅱ,6cases of CINⅢ,4cases of cervical cancer. The chi-square test (χ2=103.216, P<0.0005) shows that the result had obvious relationships between TCT and pathology.2. The pathology of95HC2-negative cases included77cases of normal,9cases of CIN I,7cases of CIN Ⅱ.2cases of CINⅢ. none of cervical cancer. The pathology of209HC2(1～1000pg/ml) cases included114cases of normal,29cases of CIN Ⅰ,40cases of CIN Ⅱ,24cases of CINⅢ,2cases of cervical cancer. The pathology of38HC2(>1000pg/ml) cases included7cases of normal,8cases of CIN Ⅰ,lleases of CIN Ⅱ,9cases of CINⅢ.3cases of cervical cancer.. The positive result rate of pathology increased with the detection value of HC2. and the rate of high grade cervical lesion increased with it too. The chi-square test (χ2=248.093, P<0.01) shows that there were stong correlation between HC2and pathology.3. The pathology of178cases patients whose TCT and HC2are both positive included67cases of normal.26cases of CIN Ⅰ.49cases of CIN Ⅱ.31cases of CINⅢ,5cases of cervical cancer. Combining TCT and HC2, the sensitivity is95.83%, the specificity is27.27%, the positive prediction value is48.94%. the negative predictive value is90.00%, the false positive rate is72.73%, and the false nega(?)e rate is4.17%.4. With the colposcopy used to detect cervical lesion, the sensitivity of acetic test and iodine test is98.61%, and92.31%respectively.The sensitivity of acetic test is better than iodine test (χ2=115.327, P<0.01). The sensitivity of TCT and acetic test is87.50%and98.61%respectively(P<0.01).5. In the cases which TCT grade≥ASCUS, the false positive rate is43.48%with combining HC2, and84.37%with combining acetic test. The chi-square test (χ2=27.330, P<0.01) shows that false positive rate of acetic test is higher than HC2.Conclusions:1. There was a postive correlation between the aggravation of TCT degree and the extent of cervical disease.2. When the HPV viral load was higher than1000pg/ml, the risk of developing high level cervical lesions significant increased.3. The combination of TCT, HC2and colposcopy had a100%negative predictive value of cervical disease, that is the biopsy is unnecessary.4. HC2are recommended as further screening to the patients, who are diagnosed with ASCUS and the degree above it by TCT.5. The positive prediction value of Pap smear samples is48.94%.