| Background and objective:The incidence of cervical cancer(CC)in women in developing countries’ malignant tumors ranked second,the number of China died from cervical cancer each year nearly 50 thousand,the incidence of cervical cancer showed a younger trend in recent years,but the development of cervical cancer is a relatively long process,from cervical precancerous lesions to early carcinoma and invasive carcinoma is a continuous process of development,needing 10-15 years.Therefore,cervical cancer screening is the key to reduce the incidence and mortality of cervical cancer.Methods of screening for cervical cancer with Thinprep Cytologic Test(TCT),Human Papilloma Virus(HPV)and the combination of the two screening test,The purpose of this study was to investigate the value of Thinprep Cytologic Test(TCT)and Human papilloma Virus(HPV)detection and two joint screening for cervical cancer screening.Materials and methods:1.Research object: 9756 patients with TCT and HPV were selected from January 2015 to January 2016 in Jilin University Bethune First Hospital,excluding with acute genital tract inflammation,cervical conization and hysterectomy history and pelvic radiotherapy in patients with a history ofexclusion,selected 1025 cases of patients with cervical biopsy as the research object,age 19-84,informed consent.2.Research methodology2.1 TCT examination The patients within three days prohibit sexual life,vaginal irrigation and vaginal medication.Check the liquid based cell collection special brush placement in the cervix,cervical squamous columnar junction in the same direction of rotation 5 laps,placed in the cell preservation liquid rinse.The new PAT’S automatic cell production machine.The TBS cytology grading system(2006): no intraepithelial lesion cells or malignant cells(NILM);diagnosis including equivocal cervical atypical squamous cell of abnormal cytology(ASC-US),high grade squamous intraepithelial lesions cannot exclude cervical atypical squamous cells(ASC-H),low-grade squamous intraepithelial lesion(LSIL),high-grade squamous intraepithelial lesion(HSIL)and cervical squamous cell carcinoma(SCC),atypical glandular cells(AGC)and adenocarcinoma Results:TCT was negative for NILM,and the rest were positive.2.2 HPV examination Check with the cotton swab around the cervix and cervical mucus wipe,special cervix sampler in 1-1.5cm,clockwise 3 laps,the secretions and stored in the special collection sampler tube.The second generation hybrid capture assay(HC2)was used to detect 16,18,31,33,35,39,45,51,52,56,13,58,and 68 types of high-risk HPV.Results: the judgment standard of HPV-DNA in the samples of load ismore than 1.0ng /L positive results.3.statistical methods using SPSS13.0 statistical software for data analysis,the comparison between the data of each group was analyzed by chi square test,was statistically significant difference(P<0.05).Results:1.Based on gold standard of pathological results,compared with the positive rate of high-risk HPV infection in patients with LSIL、HSIL and CC,the positive rate of high-risk HPV infection in patients with normal or inflammatory tissue pathological examination have significant difference(χ2=211.77,P=0.0000).2.The higher the level of TCT examination results,the lower the false negative rate of screening(χ2=11.00 P=0.0117);The higher the level of TCT examination results,the higher the pathological grade(χ2趋势=691.22,P=0.0000).3.The sensitivity of TCT combined with HPV is significantly higher than that of separate TCT inspection and HPV detection.Conclusions:1.The high-risk HPV infection is associated with cervical precancerous lesions and cervical cancer.The higher the level of TCT examination results,the lower the false negative rate.We should pay enough attention to it.2.The high age of cervical cancer has got earlier.3.TCT combined with HPV screening can reduce the false negative rate of cervical cancer screening,is the most ideal method for cervical cancer screening. |
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