The Value Of Combined Detection Of HR-HPV And CLDN4 In The Diagnosis Of Cervical Precancerous Lesions

ObjectivesTo investigate the diagnostic value of HR-HPV combined with CLDN4 detection in cervical precancerous lesions.Methods:20 patients from the Gynaecological Clinic of Run Run Shaw Hospital affiliated to Zhejiang University from June 2015 to December 2016 were selected.According to the results of colposcopy and pathological biopsy,the patients were divided into four groups:low-grade squamous intraepithelial lesion group(LSIL group,30 cases),high-grade squamous intraepithelial lesion group(HSIL group,30 cases),cervical cancer group(30 cases)and chronic cervicitis group(30 cases).HR-HPV and TCT were detected in all patients.The expression of CLDN4 protein in cervical tissue and the mRNA level of CLDN4 were detected by immunohistochemistry.To analyze the value of HR-HPV combined with CLDN4 in the diagnosis of cervical precancerous lesions.Results:(1)The positive rate of HR-HPV in the control group was lower than that in the cervical precancerous lesion group(P<0.05).At the same time,with the aggravation of cervical precancerous lesions,the infection rate of HR-HPV also increases;(2)The intensity of CLDN4 protein expression is closely related to the degree of cervical precancerous lesions,and the more serious the precancerous lesions of the cervix,The level of CLDN4 expressed in tissues increased(?=0.832,P<0.05).(3)The expression of CLDN4 was up-regulated with the severity of cervical precancerous lesions.(4)The positive expression of HR-HPV infection and CLDN4 was mainly observed.In the precancerous lesion group,it was significantly higher than the control group(P<0.05).At the same time,with the aggravation of precancerous lesions,the positive rate of combined detection of HR-HPV and CLDN4 was higher;(5)HR-HPV+in cervical precancerous lesions.There were 92 cases with positive CLDN4 and 90 cases with positive TCT+HR-HPV.The sensitivity of CLDN4 combined with HPV in the diagnosis of cervical precancerous lesions was 96.7%,accuracy 46.7%,specificity 30.0%,positive predictive value 58.0%and negative predictive value 90.0%;TCT combined with HR-HPV sensitivity to the diagnosis of cervical precancerous lesions The degree was 100.0%,the accuracy was 55.0%,the specificity was 36.7%,the positive predictive value was 61.2%,and the negative predictive value was 100.0%.There was no statistical difference between the two(P>0.05).Conclusions:(1)HR-HPV and CLDN4 have higher detection rates for cervical precancerous lesions;(2)CLDN4 expression is closely related to the severity of cervical precancerous;(3)HR-HPV combined with CLDN4 and HR-HPV combined with TCT for cervical cancer There is no significant difference in the detection rate of lesions.HR-HPV combined with CLDN4 can be used as an important means to diagnose cervical precancerous lesions.