| Objective To explore the diagnostic value of LCT and HPV alone and combined examination in cervical lesions,and to explore the clinical value of cells free ferrous protoporphyrin(FH)detection in cervical lesions by the new method of cervical cancer screening in cervical microenvironment.Methods A total of 685 patients who underwent LCT examination,HPV examination and pathological examination in Anhui Provincial Hospital from September 2015 to November 2017 were collected.The pathological examination results were used as the gold standard for diagnosis.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of LCT and HPV examinations combined in cervical lesions were calculated to compare LCT with HPV alone and in combination.Check the diagnostic value of cervical lesions.A total of 110 subjects with FH,LCT,and pathological findings were also collected,as well as 120 subjects with FH,HPV,and pathological findings.The colposcopic cervical biopsy results were used as the gold standard for diagnosis.The sensitivity,specificity,false positive rate,false negative rate and accuracy of the two methods were analyzed to evaluate the clinical application of FH detection in cervical lesions value.All subjects were aged 20-60 with an average age of 41.6 ± 9.45.All signed informed consent,research programs approved by the Medical Ethics Committee of xxxx Hospital.Results In 685 patients who underwent both LCT and HPV tests,the sensitivity of HPV test was 90.48%,the specificity was 58.74%,the positive predictive value was 49.22% and the negative predictive value was 93.31%.The sensitivity of LCT was 62.38%,Specificity was 90.95%,positive predictive value was 75.29%,negative predictive value was 84.54%.The combined sensitivity of HPV and LCT was 93.33%,the specificity was 53.68%,the positive predictive value was 45.58% and the negative predictive value was 94.51%.Among the 110 subjects who underwent both FH and LCT examinations,the sensitivity of FH detection was 80.77%,the specificity was 65.52%,the false positive rate was 34.48%,the false negative rate was 19.23%,and the compliance rate was 72.73%.The sensitivity of LCT was 67.31%,the specificity was 84.48%,the false positive rate was 15.52%,the false negative rate was 32.69%,and the coincidence rate was 76.36%.Compared with the two detection methods,the sensitivity of FH detection was higher than that of LCT,but the specificity was lower and the false positive rate was higher.Among the 120 subjects who underwent both FH and HPV tests,the sensitivity of FH detection was 70.59%,the specificity was 73.91%,the false positive rate was 26.09%,the false negative rate was 29.41%,and the compliance rate was 72.50%.The sensitivity of HPV examination was 76.47%,the specificity was 78.26%,the false positive rate was 21.74%,the false negative rate was 23.53%,and the compliance rate was 77.50%.There was no statistically significant difference between the two methods.Conclusion 1.The positive rate of HPV test and pathological changes of cervical lesions have a significant correlation;as the severity of cervical lesions increased,the detection rate of LCT increased accordingly.2.High-risk HPV screening is more sensitive than cytology,while the specificity is relatively poor.3.LCT combined with HPV examination significantly increased the detection rate of cervical lesions.4.Compared with LCT examination,FH detection has slightly higher sensitivity,lower specificity and higher false positive rate.Compared with the HPV test,the sensitivity,specificity,false positive rate,false negative rate,and coincidence rate of the FH detection method are less different from the HPV test.6.FH detection is simple,economical,and quick.It may be used for clinicians to judge the patient’s cervix temporarily and roughly,and there are no professional pathologists,professional instruments,and laboratory primary care areas.In addition,large-sample,multi-center experimental validation is also required. |
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