| Objective:To investigate the value of the folate receptor-mediated cervical staining(FRD) in cervical cancer and cervical neoplasia screening.Methods :From January 2014 to July 2015, patients were selected for the study, while patients wentthrough with FRD staining, thinprep cytologic test,TCT each one of them prompt positive, FRD staining prompted positiveor TCT showed AGC or ≥ASCH,underwent vaginal examination, and the pathological results were the gold standard.Results:Totally, there are 207 cases whose FRD staining and(or) TCT test showed abnormal.204 of them went through colposcopy biopsy. The women ranged in age from 20 to65 years, mean age was 43.15 ± 11.34 years. 144 cases of them showed positive FRD staining results, of which abnormal cervix staining in 101 cases(49.51%), abnormal cervical canal staining in 2 cases(0.98%), staining both in the cervix and cervical canal were abnormal in 41 cases(20.10%). 134 cases of them showed abnormal TCT test results, including 16 cases of ASC-H(7.84%), 67 cases of LSIL(32.84%), 48 cases of HSIL(23.53%), 3 cases of AGC(1.47%). Pathological findings: 79 cases of normal or cervical inflammation or LSIL,103 cases of HSIL(50.49%), and 22 cases of cervical cancer(10.78%).Compared with pathological diagnosis, FRD special staining for normal cervical epithelium or inflammatory, LSIL, HSIL and cervical cancer diagnosis coincidence rate were 74.47%, 43.75%, 89.32% and 100.00%. TCT examination were 68.09 percent, respectively, 56.52%, 80.58% and 100.00%. We defined HSIL and above in pathological diagnosis as positive result. Sensitivity of FRD staining was 91.20%and specificity was 60.03 %, positive predictive value was 79.17 %, negative predictive value was 81.67%, diagnostic accordance rate was 79.90%, Kappa values was 0.56; sensitivity of TCT test was 84.00 %, specificity was 63.29 %, positivepredictive value was78.36 %, negative predictive value was 71.43 %, diagnostic accordance rate was 75.98%, Kappa value was 0.48. Both results did chi-square test,p = 0.08, the difference was not statistically significant. The AUC(95%CI) was 0.930(0.694~0.838)for FRD staining, and 0.736(0.663~0.810)for TCT test.Conclusions :In this study, we examined the application in screening of cervical lesions by comparison with TCT examination and FRD special staining to explore the clinical significance of FRD staining.The value of FRD staining for screening of cervical lesions has no difference with TCT examination. What’s more, FR is low expressed in normal cells, but overexpressed in tumor tissue. High affinity targeting to tumor makes it has no significant adverse reactions to normal tissues; Folicacid, a small molecule, can be penetrated into the entity quickly and completely ensures the screening result show up immediately; low immunogenicity, cheap, easy storage.FRD staining provide a novel, rapid and simple screening method for cervical cancer screening. Especially for the less economical developed areas of China and the fewer pathologist area of cervical cancer screening.Results of this study showed that FRD staining solution for screening of cervical lesions have some diagnostic value, but the study is limited. Whether it can use in clinical, is depending on further experimental research. |
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