| Background and objectiveThe uterine cervical carcinoma remains a serious public health problem in developing countries,and China is no exception.According to the statistics of International Agency for Research on Cancer in 2012,there were about 266,000 cases of cervical cancer deaths in the world,and accounting for 7.5% of all female cancer deaths,and 85% of cervical cancers distributeed in developing countries.China's population accounted for about 1/5 of the world,the burden arising from of cervical cancer had a significant impact on global.With the promotion and popularization of some screening measures,many precancerous lesions and early cancers of cervical have got prevention and treatment.According to statistics of the Ministry of Health,from the 1850 s to 1890 s,the rate of cervical cancer detection was from 145/100,000 to 8.2/100,000.However,the data from 2003 to 2010 showed that the incidence and mortality of cervical cancer in the 21 st century conversely increased.Study estimated that new cases of cervical cancer were 61,691 in 2012.By 2030,new cases of cervical cancer will rise to 93,500,and by 2050 will reach to 186,600,of which the burdens such as social,economic and so on would have important implications in the world.Cervical cancer is the most common tumor associated with infections.Studys have found that the occurrence of cervical cancer and precancerous lesions are associated with the infection of human papillomavirus(HPV).More than 100 types of HPV subtypes have been found,and 13 types of them are identified as subtypes of cancer.But the type HPV16 and 18 are the most important.The average age of the women infected is about 20 years old.It is estimated that 80% percent of sexually active women will be infected with HPV at a time.But more than 90% percent of infections are temporary.Although reinfection of same subtypes of HPV or infections of different subtypes of HPV may occur,the infections may be cleared through immune response in 6-18 months in general.HPV testing can only be judged whether with HPV infection,but it is unable to determine whether it is a persistent infection.Therefore,HPV testing for the screening of cervical cancer and precancerous lesions still has some limitations.Technical of cervical cytology is simple and convenient,which plays a very significant role in the screening of cervical cancer,especially the application of thinprep cytology test of cervical in recent years.But the professional competence of cytology doctor is limited and subjectivity is obvious,which have a significant impact on Cervical cancer screening.This study compares and analyzes the correlation between cervical cytology,HPV typing testing and cervical biopsy,which will provide materials for screening of cervical cancer and precancerous lesions.MethodsCollecting the cases which came from Department of Pathology in the First Affiliated Hospital of Zhengzhou University from July of 2014 to December of 2015.Thinprep cytology test of cervical of these cases which all had taken an HPV testing in Department of Laboratory were atypical squamous cells(ASC)and above.According to the lesion severity of cervical cytology,these cases were divided into the following four groups: atypical squamous cells,low grade squamous intraepithelial lesions(LSIL),high grade squamous intraepithelial lesions(HSIL),squamous cell carcinoma(SCC).A comparison of the difference of high risk human papillomavirus(HR-HPV)positive rates between each group had been made in this study.In addition,we compared and analyzed the cervical biopsy by colposcopy in patients with atypical squamous cells,not the exception of high grade squamous intraepithelial lesions(ASC-H)and atypical squamous cells of undetermined signification(ASC-US),and the relationship of HR-HPV in patients of ASC-US with results of pathological biopsy by colposcopy.In this study,we all regarded the cervical biopsy by colposcopy as a diagnostic criteria.SPSS17.0 statistical analysis software was used in this study with ?=0.05 as the test standards.We regard it as multiple infections when there are two or more types of HPV infections.For multiple infections,we take the various HPV subtypes repeat.Results1.The HR-HPV positive rates of ASC,LSIL,HSIL and SCC group were respectively 47.56%(175/368),66.67%(42/63),76.34%(100/131)and 83.33%(20/24)in the 586 cases with TCT abnormal.The HR-HPV positive rates between four groups used ?~2 test,and there was a statistically significant difference(?~2 =42.55,P<0.05).2.The cases of ASC-US and ASC-H who had cervical biopsy by colposcopy in the 368 cases of ASC were respectively 215,74.The detection rates of HSIL and above in cervical biopsy were respectively 15.35% and 66.22% in the group of ASC-US and ASC-H.The detection rates of HSIL and above between two groups used ?~2 test,and there was a statistically significant difference(?~2 =70.09,P<0.05).3.There were 93 HR-HPV positive cases in the 215 cases of ASC-US,and the HR-HPV positive rate was 43.26%.We had confirmed that patients with inflammation were 146 cases through cervical biopsy in 215 cases of ASC-US,and accounting for 67.91%.The cases of LSIL,HSIL were respectively 36,33,and respectively accounting for 16.74%,15.35%.The detection rate of HSIL was 29.03%(27/93)in group of HR-HPV positive cases,and 4.92%(6/122)in group of HR-HPV negative cases.The detection rates of HSIL between HR-HPV positive group and HR-HPV negative group used ?~2 test,and there was a statistically significant difference(?~2 =23.62,P<0.05).4.There were 93 HR-HPV positive cases in the patients of ASC-US.110 times of HR-HPV were detected in HPV typing testing(including double,triple and even quadruple infections).15 subtypes of high HR-HPV were detected,including six major subtypes followed by HPV16,58,52,33,18,51.The highest rate of HPV positive was the subtype 16,accounting for 36.56%.The following subtype was HPV58,with a positive rate of 27.96%.The detection rate of HSIL was 17.20%(16/93)in the group of HPV16 positive cases,and 5.38%(12/93)in the group of HPV58 positive cases.The detection rates of HSIL between HPV16 positive group and HPV58 positive group used ?~2 test,and there was a statistically significant difference(?~2 =5.02,P<0.05).Conclusions1.With the increasing of severity of cytology,the HR-HPV positive rates showed an increasing trend.2.Six major high risk subtypes followed by HPV16,58,52,33,18,51 were checked out in the group of ASC-US.A single infection was the main,followed by double infections,partly for mixed infections of high risk HPV and low risk HPV.In the high risk subtypes,HPV16 was the most common type,and followed by HPV58. |
PDF Full Text Request