The Clinical Application Value Of Combined Detection Of HPV DNA And HPV E6 Protein In Cervical Cancer

Objective:Compared the detection rate of combined detection of HPV DNA and HPV E6 protein in normal cervical issues, at all levels of cervical intraepithelial neoplasia and cervical cancer. Use statistical methods to evaluate two measurement methods in the clinical application value of cervical cancer screening.To provide reference for early diagnosis, treatment, condition evaluation and prognosis of cervical intraepithelial neoplasia and cervical cancer. To provide guidance for cervical cancer epidemiology investigation. Methods:The research objects were from gynaecology of Jilin university China-Japan union hospital from October of 2013 to October of 2015. Choose 681 cases whose Cervix liquor tabular cell test(TCT) were positive(ASC- US and above lesions for TCT positive), aged 20 to 84 years old, with an average age of 42. All patients whose Cervix liquor tabular cell test(TCT) were positive were performed human papillomavirus(HPV) DNA testing, HPV E6 protein detection and cervical biopsy with pathological results as the gold standard, analysis and compare the clinical value of the detection of HPV DNA and HPV E6 protein in cervical lesion screening. Results:1. In the 681 patients, 98 patients were diagnosed with CIN I, 57 patients were diagnosed with CIN Ⅱ, 35 patients were diagnosed with CIN ⅡI,16 patients were diagnosed with cervical cancer.475 patients were diagnosed with normal cervix. By trend χ2 test of HPV DNA and HPV E6 protein positive rate of different pathologival types patients, the difference has statistical significance(respectively are χ2=10.1,P< 0.01,χ2= 234.4, P < 0.001),which means the CIN lesions increase with pathological changes,HPV DNA and HPV E6 protein positive rate showed a trend of growth.2. With pathological detection as the gold standard, the HPV DNA detection sensitivity was 89.8%(185/206), specificity was 20.6%(98/475), positive predictive value was 32.9%(185/562), negative predictive value was 82.4%(98/119).3. With pathologic results as the gold standard, the E6 protein sensitivity was 60.7%(125/206), specificity was 90.5%(430/475), positive predictive value was 73.5%(125/170), negative predictive value was 84.1%(430/511).4. 206 patients were diagnosed CIN I group,CIN Ⅱ,CIN ⅡI group, cervical cancer by cervical histopathological examination, Among them, the positive rate of HPV DNA testing was respectivel 87.8%, 91.2%, 97.1%,100%.the positive rate HPV E6 protein dectection was respectively 49.0%、54.4%、85.8%、100%With the increase of premalignant cervical lesion and cervical lesion degree, the positive rate have obvious rise among the two methods. Between them, The positive rate detected by HC-Ⅱ high rise HPV detective method is much higher than HPV E6 protein detective method. And it is more obvious with the deterioration of cervical tissue properties, and the positive detective rate by the two method all reached 100%. There are no misdiagnosed cases between the two methods in certical cancer. In CIN Ⅱ and below lesions, the positive expression of HPV DNA is 1.7 times of HPV E6 protein. But in CIN ⅡI and above lesions, the positive rate is close between DNA and E6 protein, there are no stistical differences for the positive detective rate between them(χ2=0.36,P=0.55).5. The sensitivity of combined detection of HPV E6 protein and HPV DNA in HPV E6 protein and HPV DNA is 93.7%. For the pathological positive patients, the comparison of HPV E6 protein,HPV DNA and the detective rate in CIN group and cervical cancer group has statistical significance.(χ2 =12.9,P <0.05), the joint detection rate is higher than single HPV E6 eggs detection and HPV DNA detection. Conclusion:1. Detection of high risk HPV DNA has a high degree of sensitivity and high negative predictive value, it is still the current clinical go up to the most effective method for cervical cancer screening.2. Detection of HPV E6 protein is of higher specificity, it has certain clinical predictive value for high degree cervical intraepithelial neoplasia.3. The detection rate of HPV E6 protein and HPV DNA in cervical lesions increase withthe growth of pathological changes. The combined detection of HPV E6 protein and HPV DNA can improve the detective rate for cervical lesions. It can provide reference for early diagnosis, treatment, condition evaluation and prognosis of cervical intraepithelial neoplasia and cervical cancer.