Discussion Of The Clinical Value Of Biopsy Of High-risk HPV Positive

ObjectiveTo explore the clinical value of direct colposcopy biopsy in the patients of High-risk Human papilloma virus positive. MethodsCollect the outpatient cases from June 2014 to June 2015 in our hospital who accept cervical cancer screening,the application of PCR fluorescence to detect high-risk HPV- DNA(including high-risk type 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68), Totally 600 positive ones acccept liquid based cytology test(TCT) and pathological biopsy meanwell。 Results1.hr HPV positive ones: HPV16 type 246 cases(41%);HPV52 type 150cases(25%);HPV18 type 126 cases(20.67%);HPV58 type 116cases(19.33%).2.Hr HPV alone positive ones, HPV16 type 128 cases(21.33%);HPV52 type 42 cases(7%); HPV18 type 38 cases(6.33%); HPV58 type 36 cases(6%); HPV51 in 21 cases(3.5 %).3.There are 6 cases of cervical cancer in the Hr HPV alone positive patients, including 5 cases hr HPV16 or 18 positive(80%). The total number of cases of a single type of HPV infection is 353, accounting for 58.83%. Multiple infections 247 cases, accounting for 41.17%. Multiple infection increased coinfected with infection type numbers,while the ratio declined. In single infection ones the biopsy positive rate was 49%, and multiple infection ones is 53%, the difference was not statistically significant when compared the rate of cervical leisions in single type infection and multiple(x2=14.83,P >0.05).4.Group16 / 18 positive pathological biopsy positive rate was 59.33%(194/327), The positive predictive value was 63.40%(194/306);the other type of HPV positive pathological biopsy positive rate was 41.03%(112/273).Group 16/ 18 positive result in CINII and above the lesions rate was 51.07%, and other hr HPV positive the rate was 24.91%, the former is significantly higher than the latter, the difference was statistically significant( P < 0.05).5.193 patients were with high-risk HPV positive and negative of TCT, there were 126 cases of HPV16 / 18 positive, the positive biopsy rate were 37.30%(47/126);Other HPV positive 67 cases, the positive biopsy rate were 32.84%(22/67);compared with pathological biopsy, positive predictive value of the TCT detection of other HPV positive was 43.14%(88/204), negative predictive value was 66.18%(45/68), the diagnostic coincidence rate was 48.90%(133/272).Totally there were 69 cases whose TCT were negative but pathology were positive, including CINI 27 cases, CINII 10 cases, CINIII 30 cases, 2 cases of cervical cancer, the sensitivity of the TCT examination was 77.45%(237/306), the misdiagnosis rate(false negative rate) was 22.55%(69/306)。 ConclusionsClinically, We suggest that high-risk HPV16/18 positive patients should do pathological biopsy, other hr HPV positive patients also should do the pathological biopsy.