Prior TCT And HPV Testing Results In 503 Patients With Cervical Cancer

Objective:To investigate the limitation of Thinprep cytologic testing and HPV testing in detecting invasive cervical cancer.Methods:503 patients with histologically diagnosed cervical cancer,Pap cytology and/or HPV testing in the year prior to diagnosis were retrospectively studied that admitted to the Second Hospital of Shanxi Medical University from January,2004 to December,2014.The detection results of 402 cervical cancer patients with prior TCT test results,391 cervical cancer patients with prior HPV results,and 294 cervical cancer patients with prior HPV and TCT test results were descriptively analyzed through SPSS 20.0 statistical software.Results:1.Carcinoma types are 503 patients of cervical cancer included 486 patients with squamous cell carcinoma(96.62%);15 with adenocarcinoma(2.98%);1 with adenosquamous carcinoma(0.20%);and 1 with cervical sarcomatoid carcinoma(0.20%).2.402 of 503 patients with cervical cancer had TCT testing results performed in the 1 year before histologic diagnosis.Among the 402 patients with cervical cancer,297 patients showed abnormal TCT results(73.88%)and 105 patients showed TCT negative test(26.12%).The TCT negative rate was significantly higher in patients with adenocarcinoma than in patients with squamous cell carcinoma(36.36% vs 25.96%)(P<0.05).3.391 of 503 patients with cervical cancer had HPV testing results performed in 1 year before histologic diagnosis.The HR-HPV positive rate was 82.86%,and the HR-HPV negative rate was 17.14%.The HR-HPV positive rate was 83.51% in patients with squamous cell carcinoma.HR-HPV positive rate was 61.54% in patients with adenocarcinoma.The HR-HPV negative test was higher in cases of cervical adenocarcinomas(38.46%)compared to cervical squamous cell carcinoma(16.49%)(P>0.05).HPV typing analysis results showed that the most common HR-HPV genotypes were HPV16,HPV18,HPV52,HPV58,and HPV33.4.294 of 503 patients with cervical cancer had HPV and TCT testing results performed in 1 year before histologic diagnosis.Within this group of patients,the negative rate of TCT test was 27.55% and the negative rate of HR-HPV test was 16.33%.The HR-HPV negative rate was significantly lower than the TCT test negative rate in this group of patients(16.33% vs 27.55%)(P<0.05).20 cases of these patients had double negative results with both TCT and HPV testing(20/294,6.80%).5.Nine patients with cervical cancer had HPV and TCT testing results within the 1 year time period before histological diagnosis.Six cases were HR-HPV positive.Three cases were HR-HPV negative.Four cases were TCT test negative.There were one case of ASC-US,one case of LSIL,one case of HSIL,and one case of AGC.All the three HR-HPV-negative cervical adenocarcinomas were typical adenocarcinomas.The HR-HPV negative rate was significantly lower than the TCT negative rate in these cases of cervical adenocarcinoma(11.11% vs 44.44%)(P>0.05).There was 1 case of co-testing negative results.Conclusion:1.There were a few negative results of TCT in cervical cancer.The negative rate of TCT test in patients with cervical adenocarcinoma was higher than that in patients with cervical squamous cell carcinomas.2.There were a few negative results of HR-HPV in cervical cancer.The negative rate of HR-HPV test in patients with cervical adenocarcinoma was higher than that in patients with cervical squamous cell carcinomas.3.There is a certain proportion of co-testing negative in cervical cancer.