The Role Of High-risk Human Papillomavirus In ASCUS Population Triage

Background and purposeCervical cancer is the most common gynecologic malignant tumor,its occurrence and development is a long-term,multi stages and multi factors process.epidemiological studies have found that high-risk HPV persistent infection is the main factor of cervical cancer.After the high risk HPV infection of the cervix,it can integrate its genomic DNA into the host cell genome through the way of non homologous recombination in,and then a large number of oncogenes E6,E7 mRNA was transcribed,resulting in high expression of HPV E6/E7 oncoprotein.E6 and E7 oncoprotein,respectively,combined with p53 protein and pRb protein,inhibit the inactivation of tumor suppressor gene p53 and pRb,damage the cell DNA,activate the telomerase activity,cause the over proliferation of cells,trigger the cell immortalization and malignant transformation,and finally lead to the occurrence of cervical cancer.Cervical intraepithelial lesions can reflect the evolution process of the occurrence and development of cervical cancer.The key to prevent the occurrence of cervical cancer,is cervical cancer early diagnosis and early treatment and cervical intraepithelial neoplasia screening.Liquid based cytology(TCT)diagnostic reports based on the TBS classification system were applied to early screening of cervical diseases and improved the positive rate of cervical lesions diagnosis.As a screening method of cervical cancer,HPV detection has been paid more and more attention,and has gradually changed the screening strategy of cervical cancer.When the cytology report is ASCUS,there will be a lot of differences in clinical treatment,how to triage patients with ASCUS has become a hot research topic in recent years.Therefore,this study based on hospital in,by detecting high-risk HPV infection fin patients with ASCUS,to study the role of high-risk HPV in the ASCUS population flow.It has important scientific significance and practical value.The results of the study can optimize the screening strategy of cervical cancer,and ultimately achieve the purpose of reducing the incidence and mortality of cervical cancer in women.Materials and methods:1 Clinical data: A total of 179 cases of women whose liquid based cytology were ASCUS and had cervical biopsy under colposcopy from January 2015 to August 2016 in the Second Affiliated Hospital of Zhengzhou University Department of gynaecology were selected as the research object.2 Data collection methods: Patients were collected by questionnaires,and the age,marriage,sexual life,monthly income,education,family history and other basic information were collected.3 Specimen collection: Cervical exfoliated cells were collected,HC2-HPV was collected,and suspicious cancerous lesions were biopsied under colposcopy.4 Laboratory test methods: TCT detection,HC2 HPV detection,and pathological diagnosis.5 Quality control: In this study,questionnaire survey,data entry,laboratory testing phase were taken quality control.6 Statistical methods: Chi square test was used to compare the results of the counting data,and the test level was 0.05.Results:1.Of the 179 subjects,the oldest was 65 years old and the youngest was 21 years old,mean age was(42.55±10.44)years.There were 145 cases married and unmarried 34 cases.2.The pathological results were as follows: cervicitis,CINI,CINII,CINIII and cervical cancer was respectively 128 cases,20 cases,27 cases,4 cases.The detection rate of CINII+ was 17.32%.3.High-risk HPV was positive in 67 cases,the infection rate was 37.43%.The detection rate of CINII+ in HPV positive group was 38.81%(26/67).The detection rate of CINII+ in HPV negative group was 4.46%(5/112),the difference was statistically significant(?2=38.81,P<0.05).4.The high-risk HPV positive in CINI,CINII and CINIII+ respectively was 12 cases,22 cases,4 cases,the infection rates respectively was 60.00%,81.48%,100.00%.The difference was statistically significant(?2=45.53,P<0.05).5.The effectiveness of high risk HPV in predicting lesions in ASCUS patients:sensitivity is 83.87%,specificity is 61.49%,positive predictive value is 29.88%,negative predictive value is 95.54%.Conclusion:1.HR HPV testing can be used as a triage index for ASCUS population,which can effectively detect high grade lesions and reduce unnecessary referral.