The Clinical Value Of Tru Screen In The Cervical Cancer Screening

Background and Objective:Cervical cancer originated from cervical intraepithelial lesions is the most common malignant tumor in the female reproductive system.It is also the only malignant tumor with definite etiology.With the change of people's lifestyle,the number of people suffering from the disease is increasing,and the incidence showed younger trend,which is a serious threat to the health of women.The occurrence and development of cervical cancer is a continuous and long process,from cervical precancerous lesion to cervical cancer,which takes several years to ten years.Therefore,early detection and intervention through effective screening methods,can prevent cervical cancer to a certain extent.In western developed countries,the prevalence of cervical cancer screening technology has enabled early detection and treatment of cervical cancer and precancerous lesions,with a significant decrease in incidence and mortality.Cervical cancer screening is the most commonly used cytological screening However,the traditional cervical cytology screening requirements for various aspects such as filming and material selection make the screening sensitivity low and the false negative rate higher.The thinprep cytologic test is widely used in China now.Its sensitivity is improved,but it still needs professional cytopathology technicians to read films under microscope,which has certain subjectivity.Screening for cervical cancer is restrictive in the general development of the grassroots.Therefore,seeking a real-time,objective and efficient screening system,early detection of cervical lesions and treatment,is of great significance for controlling the incidence and mortality of cervical cancer.The purpose of this study was to detect the clinical value of cervical cancer screening system(TruScreen,TS)in precancerous lesions and cervical cancer screening.Methods:From September 2016 to March 2017,94 patients who planed to have total hysterectomy because of uterine myoma,adenomyosis or ovarian tumors were selected from our hospital.Before surgery,TS was used for screening,and then thinprep cytology test was used to detect the results.Patients with abnormal TCT results required further colposcopy biopsy to determine the scope of surgery.Those with normal TCT results underwent total hysterectomy as planned.The TCT results were taken as the reference,and the pathological results after total hysterectomy were the gold standard.The sensitivity,specificity,positive predictive value,negative predictive value,false negative rate and false positive rate were calculated by SPSS23.0 software.The consistency of TS,TCT and pathological results was calculated by Kappa consistency test,The consistency degree was evaluated by Kappa value.0.4?Kappa<0.75 was of moderate consistency,and Kappa?0.75 was very consistent.The diagnostic value of TS and TCT was evaluated by ROC curve analysis,and the area under the ROC curve(AUC)was calculated to evaluate its diagnostic accuracy.The diagnostic accuracy was moderate with 0.7<AUC?0.9,and the diagnostic accuracy was higher with 0.9<AUC<1.Results:1.In 94 patients,the TCT results were used as a reference.The pathological results after total hysterectomy were gold standard.The sensitivity,specificity,false positive rate,false negative,positive predictive value and negative predictive value of TS for screening cervical precancerous lesions and cervical cancer were 78.95%,74.67%,25.33%,21.05%,44.11%,and 93.33%,respectively.The sensitivity,specificity,false positive rate,false negative rate,positive predictive value and negative predictive value of TCT for screening cervical precancerous lesions and cervical cancer were 68.42%,78.66%,21.33%,31.57%.,44.82%,90.75%.The sensitivity of TS to the diagnosis of LSIL,HSIL and cervical cancer was 72.73%,83.33% and 100%,respectively,while TCT was 65.55%,83.33% and 100%,respectively.2.Kappa consistency test was used to compare the consistency of TS with pathological results.Kappa=0.41,the difference was statistically significant(P<0.001).The Kappa value of TCT with pathological results is 0.394,the difference was statistically significant(P<0.001).The diagnostic value of TS was evaluated by ROC curve analysis,AUC=0.768,the diagnostic value of TCT was evaluated by ROC curve analysis,AUC=0.735,and the difference was statistically significant(P<0.001).Conclusion:1.The TruScreen Cervical Cancer Screening System has high sensitivity and specificity and diagnostic coincidence rate for cervical precancerous lesions and cervical cancer screening,which can be used in clinic.2.The TruScreen cervical cancer screening system has a moderate degree of consistency with the pathological results,and a moderate diagnostic accuracy,and the diagnosis effect is superior to that of the TCT,which has a good clinical value.3.TruScreen,because of its objective,real-time,high-efficiency,noninvasive and other advantages,can be used as a screening method for cervical cancer.