The Effect Of Combined Detection Of HPV,TCT,P16 On Screening Of Cervical Cancer And Precancerous Lesions

ObjectiveCervical cancer is a common gynecological malignant tumor,which poses a serious threat to women's health^[1-2].Cervial Intraepithelial Neoplasia?CIN?is a cervical lesion closely related to cervical cancer.Most of the low-grade cervical intraepithelial neoplasia can spontaneously subside.However,high-grade cervical intraepithelial neoplasia has the potential of canceration and may even develop into invasive cervical cancer,which is considered as precancerous lesion.Cervical cancer begins with atypical hyperplasia of cervical epithelium.It develops into invasive cancer through carcinoma in situ and takes 5-10 years or more to develop.Therefore,secondary prevention is necessary.Colposcopic biopsy is the"golden standard"for the diagnosis of cervical lesions.Precise screening before biopsy is particularly important.Therefore,the purpose of this study is to detect cervical exfoliated cells P16 in patients with HPV positive and?or?TCT abnormalities,and to observe the guiding significance of cervical exfoliated cells P16 for colposcopy,so as to improve the detection rate of cervical lesions.MethodsThe cases of HPV and TCT screening for cervical cancer in the outpatient department of the First Affiliated Hospital of Jinzhou Medical University from August 2017 to March 2018 were selected.The expression of P16 in cervical biopsy tissues was semi-quantified and the consistency between the expression of P16 in cytology and histology was determined.Results1.HPV has high sensitivity?90.5%?and negative predictive value?77.8%?in screening cervical cancer and precancerous lesions.The infection rate of HPV increases with the increase of inflammation,CINI,CINII/CINIII and pathological results of cervical cancer.The difference has statistical significance?P<0.05?,which plays an important role in clinical screening of cervical cancer and precancerous lesions.2.TCT has high specificity?52.9%?and positive predictive value?69.2%?in screening cervical cancer and precancerous lesions.The positive rate of TCT in inflammation,CINI,CINII/CINIII and cervical cancer increases with the increase of pathological grade.The difference has statistical significance?P<0.05?.TCT plays an important role in clinical screening cervical cancer and precancerous lesions.3.Semi-quantitative method was used to detect the expression of P16 in pathological tissues.The positive rate of P16 expression increased with the increase of pathological grade in inflammation,CINI,CINII/CINIII and cervical cancer?P<0.05?.The strong positive expression of P16 in high-level group CINII/CINIII and cervical cancer indicated abnormal cell regulation.P16 may be a biological marker to guide early colposcopy examination.4.There was a significant correlation between the results of cytological P16and histological P16.?r=0.640,P<0.05?5.The sensitivity,specificity and accuracy of HPV detection alone were90.5%,41.2%,68.4%,TCT detection alone was 85.7%,52.9%,71.1%,and P16detection alone was 88.1%,67.6%,78.9%,respectively.The sensitivity,specificity,accuracy of HPV and P16 combined screening were 97.6%,29.4%,67.1%,respectively.The sensitivity,specificity and accuracy of the combined screening of HPV,TCT and P16 were 97.6%,32.4%and 68.4%,respectively.The sensitivity,specificity and accuracy of the combined screening of HPV,TCT and P16 were100%,61.8%and 82.9%,respectively.It can be seen that the sensitivity and accuracy of the combined screening of HPV,TCT and P16 were higher than those of the combined screening and single screening.The combined screening can improve the detection rate of cervical lesions.ConclusionsThere was consistency between cytological P16 and histological P16.The combined detection of HPV,TCT and P16 can improve the detection rate of cervical lesions.