Clinical Value Of LCT And HR-HPV In The Diagnosis Of Cervical Intraepithelial Neoplasia

Objective To evaluate liquid-based cytology(LCT),high-risk human papillomavirus(HR-HPV) and pathological findings of cervical biopsy in the diagnosis of cervical intraepithelial neoplasia(CIN).Methods We retrospectively analyzed 1539 cases of patients in the Affiliated Hospital of Qingdao University from Jan. 2013 to Jan. 2014. All patients of LCT were further investigated by HR-HPV testing and colposcopic multiple punch biopsies. The results of LCT, HR-HPV and colposcopic multiple punch biopsies were compared in the diagnosis of CIN. We applied 2001 TBS classification system in cytological diagnosis. Atypical squamous cell of undetermined significance(ASC-US) and worse findings were regarded as positive diagnosis. Pathological findings of colposcopic multiple punch biopsy was the gold standard of diagnosis.Results 1. The findings of LCT were normal in 19151 cases( 19151/20479, 93.52%). ASC-US and worse were found in 1328 cases, the positive rate of cervical lesions was 6.48%(1328/20479).The detection rates of ASC-US,LSIL,ASC-H,HSIL, cervical cancer by LCT and colposcopic multiple biopsies were 43.55%( 334/767), 51.91%(95/183),83.19%(99/119),1.88%(181/197) and 100%(5/5), there was statistical significance among ASC-H, HSIL, and ASC-US or LSIL(P<0.05). 2.HR-HPV infection rates of ASC-US, LSIL, ASC-H, HSIL, cervical cancer respectively were 77.44%, 68.31%, 84.87%, 96.45% and 100%, there was statistical significance(P<0.05). 3. HR-HPV positive and negative rates in the groups of high-level cervical intraepithelial neoplasia were 39.85% and 5.05%, there was seriously statistical significance(P<0.01). 4. HR-HPV positive rate in high-level cervical intraepithelial neoplasia and cervical cancer was significantly higher than that of negative in the group of ASC-US, there was seriously statistical significance(P<0.01). There was no invasive cervical cancer in HPV negative group. 5. HR-HPV positive rate in high-level cervical intraepithelial neoplasia and cervical cancer was higher than that of negative in the group of LSIL, there was statistical significance(P<0.05). 6. The detection rate of high-level cervical intraepithelial neoplasia and cervical cancer in 263 cases of negative cytology and positive HR-HPV was 16.73%(44/263).Conclusion 1.Liquid-based cytology and high-risk human papillomavirus detection is an effective screening method for detecting cervical intraepithelial neoplasia, and higher diagnostic accuracy of both joint detection was found. 2. HR-HPV detection for cytologic diagnosis of ASC-US of patients has significant shunt value.3.Women with negative cytology and positive HR-HPV has the risk of high-level cervical intraepithelial neoplasia and cervical cancer.