Clinical Analysis Of Cervical Lesion Screening Mathod

ObjectiveAnalysis of cervical thinprep cytologic test(the value of Thinprep Cytologic Test(TCT)and DNA ploidy quantitative analysis and human papilloma virus(human papilloma virus,HPV)detection and three modes of joint detection in screening of cervical lesions in clinical significance.MethodsThe large sample retrospective analysis of research methods,since October January 2014 to 2015 Beijing Armey Hospital Department of gynaecology and obstetrics patients voluntarily accept the cervical cancer screening 13313 cases selected,TCT,DNA ploidy quantitative analysis and HPV detection,which TCT abnormal(including ascus and lesion)and(or)DNA ploidy quantitative analysis to abnormal(including more than or equal to three DNA ploidy abnormal cells,aneuploid peak,abnormal cell hyperplasia is more than or equal to 10%)and(or)high-risk HPV positive patients underwent colposcopy,358 cases of the cervical tissue biopsy operation,according to the Pathology were analyzed and classified as normal or inflammation,cervical intraepithelial neoplasia grade ?,cervical intraepithelial neoplasia grade ?,cervical intraepithelial neoplasia grade ?,five groups of cervical cancer,the use of statistical methods of independent samples t test,chi square test was used for statistical analysis of the data,the ROC curve by test under the receiver operating characteristic(receiver operating characteristic)curve area area is larger,the higher the value of diagnosis,according to the statistical results find cervical cancer screening the best screening program.ResultsCervical biopsy pathology study for diagnostic criteria,358 patients diagnosed by pathology and for 133 cases of normal or inflammation,accounted for 37.2%(133/358),225 cases of cervical cancer and precancerous lesions,accounted for 62.8%(225/358),high grade intraepithelial ncoplasia(CIN ? and CIN ?)in 120 patients,accounted for 33.5%(120/358);the cervical intraepithelial neoplasia become CIN ? 101 cases,accounting for 28.2%(101/358),84 cases of CIN ? and accounted for 23.5%(84/358)and 36 cases of CIN ?,accounting for 1 0.0%(36/358),cervical cancer(4 cases),accounting for 1.1%(4/358).TCT.DNA and HPV single diagnosis of cervical cancer and precancerous lesions with a sensitivity respectively for 75.1%,83.1%,88.9%,specificity were 78.9%,66.9%,61.7%,area under the ROC curve respectively 0.642,0.727,0.735,were from 0.5-1.0,have diagnostic value;three sensitivity comparison,X~2=7.636,P<0.05,the difference has statistical significance;three specificity X~2=8.1 92,P<0.05,the difference was statistically significant.Three examination of four joint TCT+HPV,TCT+DNA,DNA+HPV,the sensitivity of the TCT+DNA+HPV detection in cervical cancer precancerous lesions and cervical cancer respectively for 89.8%,85.3%,93.3%and 95.1%,specificity were 61.7%?60.9%?60.2%?60.9%?the area under the ROC curve respectively 0.871,0.726,0.954,0.962,which sensitivity differences have statistical significance,X~2=7.255,P<0.05;the specificity was no significant difference,X~2=0.554,P>0.05,AUC were between 0.5-1.0,have diagnostic value.Conclusions1.cervical lesions screening a single comparison:TCT detection of high specificity,but the sensitivity is low;HPV detection sensitivity is higher,but the specificity is low,the sensitivity and specificity of DNA ploidy quantitative analysis of the three are high;2.Combined screening:TCT+HPV joint detection and single TCT or HPV compared sensitivity is improved but the specificity is lower,improve the DNA+HPV of combined detection of a single DNA or HPV detection sensitivity but lower specificity.TCT+DNA combined detection of a single TCT or DNA detection sensitivity enhance specific reduction,TCT+HPV+DNA joint detection sensitivity compared to other detection were high,but specificity compared with the single TCT low was obviously higher than other detection;four combined detection of AUC were from 0.5-1.0,have diagnostic value and TCT+HPV+DNA joint AUC largest,most close to 1,so the highest value of the diagnosis,followed by HPV+DNA.3.To sum up;cervical cancer screening preferred TCT+DNA+HPV.The detection rate is the highest,the misdiagnosis rate is the lowest,high sensitivity,high specificity,the largest area under ROC curve,diagnostic value of the highest,it is recommended to use,but the high cost of economy;secondly HPV+DNA joint detection sensitivity and specificity is high,diagnostic value of acceptable,low economic cost,as clinical application of cervical precancerous lesions of the preliminary screening tool.