Valuation Of HPV In Cervical Cancer Screening Program Of Choice

FOREWORD: Cervical cancer is currently the most common female reproductive system malignancy, after breast cancer another big threat to women’s lives and health. With advances in cervical cancer screening methods and long-term extensive publicity and anti-cancer screening, general governance work so morbidity and mortality of cervical cancer has declined. However, recent clinical data show that cervical lesions(CIN) and early cancer getting younger and younger.Cervical intraepithelial lesions confined to the cervix,including dysplasia and carcinoma in situ, which reflects the continuous process of cervical cancer, has two different endings:one spontaneous regression of lesions; second is to continue to develop into invasive disease cancer. Whether cervical precancerous lesions and invasive cervical cancer, the current epidemiological data display sexually active, sexual premature, sexual disorders, smoking, long-term use of immunosuppressive agents, human papillomavirus(HPV) infection et al, and 90% CIN and over 95% invasive cervical cancer of patients with high-risk HPV infection. In fact, 70% to 80 % of women in their lifetime have been infected with HPV, the vast majority by their own immune system, in 1 to 2 years after infection can clear themselves. Only 10% to 15% of patients with persistent infection with high-risk HPV, cervical epithelial cells with varying degrees of precancerous lesions, and then will have the risk of cervical cancer. CIN progress to cervical cancer can take up to 10 to 15 years, so the cancer can be prevented. What means to monitor the persistence and progression of CIN? This early screening for cervical cancer indicators put forward new demands. Currently, the main method of cervical cancer screening using liquid-based cytolog-y(TCT) and HPV testing.TCT using TBS standard evaluation included no int raepithelial lesions, no clear clinical significance of atypical squamous cells, cannotexclude high-grade squamous intraepithelial lesion of atypical squamous cells, lowgradesquamous intraepithelial lesion, high-grade squamous intraepithelial lesion, no clear clinical significance of atypical glandular cells, squamous cell carcinoma and aden ocarcinoma; HC-Ⅱ can detect 13 kinds of high-risk HPV( ie HPV16,18,31,33,35,39,45,51,52,56,58,59and68) and pathological biopsy by colposcopy cervical le sions or straight down according to the national comprehensive cancer In the networ k(NCCN) to evaluate the severity of cervical cancer screening included no intrae pithelial lesions, mild to moderateatypical hyperplasia, atypical hyperplasia, carcin oma in situof severe atypical hyperplasia, microinvasive carcinoma, invasive squa mous cell carcinoma and adenocarcinoma. However,TCT is a morphological exam ination, drawn by the producer of quality and sentenced readers subjective facto rs influenced, colposcopy is an invasive and can not be found within the tiny l esions and invasive cervical canal, with a treatment program for clinicians to a great challenge. Whet-her HPV testing technology is superior tol TCT, whether HPV testing as a prima-ry screening of choice to replace TCT project remains controversial,so the article discusses this research.Objectives: To investigate clinical value study of cervical cancer screening by HPV as the preferred screening program.Methods: 124 patients with cervicallesions diagnosed in Obstetrics and gynecology Department in our hospital in the period from May 2012 to October 2013 were chosenretrospectively as research subjects. Patients using inspection methods, including TCT, HPV. In pathological tissue biopsy for diagnostic gold standard. The area under the two methods compare the sensitivity, specificity, the rate of misdiagnosis and missed diagnosis rate, ROC curve.Results: 1、CIN and SCC patients, the high incidence of age were 30 years old to 45 years old, 45 years old to 60 years old,respectively. 2、TCT diagnosis of cervical lesions sensitivity、specificity、misdiagnosis and missed rate were 61.43%、66.67%、33.33% and 38.57%, respectively; HPV diagnosis of cervical lesions sensitivity、specificity、misdiagnosis and missed rate were 92.86%、50.00%、50.00% and 7.14%, respectively. 3、HPV in cervical inflammation, CIN-1, CIN-2 / CIN-3 and cervical infection rate was 30.43%, 64.52%, 87.80%, 100.00%; With increasing severity of cervical lesions, HPV infection gradually increased(χ2 = 38.572, P <0.01). 4、TCT and HPV diagnostics cervical lesions under the ROC curve area were 0.640、0.714,respectively.Conclusion: 1、 With the increase severity of cervical lesions, HPV infection rate was significantly increased. 2、 HPV screening was superior than TCT in the early detection of cervical cancer.