The Clinical Significance Of Uterine Epithelial Cell Stability FH Detection In Cervical Lesion Screening

Objective:To investigate the clinical significance of uterine epithelial cell stability FH detection in cervical lesion screening by detecting FH substances in cervical epithelial cells.Method:The patients who were diagnosed with cervical lesions by liquid-based thin-layer cytology(TCT)and HPV typing were collected from Qingdao Women and Children's Hospital from September 2016 to November 2018 to meet the ASCCP referral colposcopy standard.According to the pathological results,244 patients were divided into control group(normal \cervicitis),low-grade disease group(CIN1 and CIN2 immunohistochemical P16(-)),and high-grade disease group(CIN2immunohistochemical P16).(+)CIN3,cervical carcinoma in situ),cervical cancer group,a total of 4 groups.All patients underwent Aptima HPV E6/E7 m RNA detection and uterine epithelial cell stability FH test before colposcopy.The TCT,Aptima HPV E6/E7 m RNA and FH test results were recorded in detail,and the results were statistically analyzed.Analysis and evaluation of the clinical value of FH testing in cervical lesion screening.Results:1.Of the 244 patients enrolled,78 were in the normal group,63 in the low-grade disease group,91 in the high-grade disease group,and 12 in the cervical cancer.2.Three test methods for separate test results:(1)The sensitivity of the three detection methods of TCT,HPV E6/E7 m RNA and FH were 74.7%,91.6%,and 82.5%,respectively,and the specificity was 82.0%,60.3%,and65.4%,respectively.The positive predictive values were 89.9%,83.1%,and 83.5,respectively.%,the negative predictive values were 60.4%,77.0%,63.7%,respectively;the coincidence rates were: 77.0%,81.6%,77.0%;Kappa values were: 51.8%,55.0%,47.6%;(2)Sensitivity comparison of three detection methods: HPV E6/E7 m RNA detection and FH detection,HPV E6/E7 m RNA detection and TCT detection were statistically significant(?2 = 6.01;16.84;P <0.05);TCT detection and FH The results of the comparison were not statistically significant(?2 = 3.03;P > 0.05)(3)Specificity comparison of three detection methods: HPV E6/E7 m RNA detection and TCT detection,TCT detection and FH detection were statistically significant(?2 =9.03;5.59;P <0.05)HPV E6/E7 m RNA detection and FH The results of the comparison were not statistically significant(?2= 0.44;P > 0.05).3.Three test methods combined detection results:(1)FH+TCT,FH+HPV E6/E7 m RNA,HPV E6/E7mRNA+TCT three detection methods were 95.8%,95.8%,97.0%,specificity 70.5%,53.8%,83.3%,respectively.The positive predictive values were 87.4%,81.5%,and 90.0%,respectively,and the negative predictive values were 88.7%,85.7%,and 92.9%,respectively.The coincidence rates were: 95.1%,89.3%,and 97.0%;Kappa values were: 87.6%,70.8%,and 92.8%,respectively.(2)There was no statistically significant difference between the two detection methods for the sensitivity of the two detection methods(?2 = 0;0.35;0.35;P> 0.05).(3)Comparison of the specificity of the two detection methods: FH+HPV E6/E7 m RNA and TCT+HPV E6/E7 m RNA,FH+HPV E6/E7 m RNA and FH+TCT are statistically significant.(?2 = 16.34;9.79;P<0.05);there was no statistically significant difference between FH+TCT and HPV E6/E7 m RNA+TCT(?2 =0.10;P>0.05).4.Three different detection methods were used to compare the results in cervical precancerous lesions::(1)HPV E6/E7 m RNA detection and FH detection: There was a statistically significant difference between the two test results(?2 = 0.68;P<0.05)(2)HPV E6/E7 m RNA detection and TCT detection: There was a statistically significant difference between the two test results(?2 = 17.11;P<0.05)(3)TCT test and FH test: There was no significant difference between the two test results(?2= 3.09;P>0.05)5.There was no statistically significant difference between the two different detection methods in the cervical precancerous lesions(?2 = 0;0.35;0.35;P> 0.05).6.FH test results in the comparison of positive rate in each level of lesions:(1)There were statistically significant differences between the control group and low-grade lesions,high-grade lesions,and cervical cancer positive rate(?2 = 11.65;64.94;18.10;P<0.05).(2)There were significant differences in the positive rate between the low-grade disease group and the high-grade disease group and cervical invasive cancer group(?2=21.80;63.19;P<0.05).(3)There was no statistically significant difference in the positive rate between the high-grade group and the cervical invasive cancer group(?2= 0.84;P>0.05).Conclusion:1.The expression of FH exudation is closely related to the degree of cervical lesions.The higher the degree of lesion,the greater the amount of FH exudation and the higher the positive rate.2.FH alone has high sensitivity(>80%),which is fast,convenient,non-invasive,etc.,and the results do not require professional pathologists to interpret,providing new insights for cervical cancer screening in remote areas and areas with scarce medical resources.Possible ideas.3.FH combined with TCT detection,FH combined with HPV E6/E7 m RNA detection,sensitivity and specificity are not as good as HPV E6/E7 m RNA combined with TCT detection,but consistent with pathological results,with high diagnostic value,worthy of clinical application.