| Background and Objective:Cervical cancer is one of the three major malignant tumors of the female reproductive system,at present it still seriously threatens the life of women.According to the International Agency for Research of Cancer(IARC)data in 2018,the incidence and mortality of cervical cancer worldwide ranks fourth among female malignancies.There are about500,000 new cases of cervical cancer in the world each year,of which the proportion of developing countries is over 80%,and the annual mortality rate is about 260,000,mainly in low-and middle-income countries.There are about 130,000 new cases of cervical cancer in China every year,accounting for 28% of the new cases in the world,including about 53,000 death cases.The incidence of cervical cancer in China has been younger in the past 10 years.In order to evaluate the significance of the cervical cancer screening,the clinical data and screening results of 1614 women have been collected,and the screening results among different ages and different reasons for treatment have been compared.The persistent infection of HPV has been identified as a causative factor of cervical cancer,and the impact factors of HPV infection have been focused.Recent studies have shown that abnormal vaginal microecology may correlated with HPV infection.To explore the relationship between vaginal microecology and HPV infection,the clinical data,vaginal microecology and HPV results in 1247 women have been collected and analyzed.Methods:1.The clinic data,HPV and TCT results of 1614 women have been collected in the Second Affiliated Hospital of Chongqing Medical University from March 1,2018 to August 31,2018.And the screening results among different ages and different reasons for treatment have been compared.The out-patients have been divided into six groups according the age: < 25 years old group,25-34 years old group,35-44 years old group,45-54 years old group,55-65 years old group,and >65 years old group.Besides,the 1614 women also have been divided into three groups: group A: routine group,no symptoms.Group B: symptoms group,patients with contact bleeding,or leucorrhea with blood,or irregular vaginal hemorrhage,or postmenopausal vaginal bleeding.Group C: recommended group,the contact bleeding or cervical abnormalities in patients during gynecological examination without symptoms.2.the clinical data,vaginal microecology and HPV tests in 1247 women have been collected and analyzed.Results:1.Clinical data analysis and screening results:1)Results of cervical cancer screening in 1614 women: 30.1%(486/1614)cases were abnormal,and 69.9%(1128/1614)cases were normal in 1614 women.The abnormal screening results have shown that,4.2%(68/1614)cases had positive HPV combined abnormal TCT,0.9%(15/1614)cases had negative HPV combined abnormal TCT,and 25.0%(403/1614)cases had positive HPV combined normal TCT.2)Comparison of cervical cancer screening results for different ages have shown that:(1)< 25 years old group(94 cases),there were 34.0%(32 / 94)cases with abnormal screening results.(2)25-34 years old group(461 cases),there were 27.1%(125/461)cases with abnormal screening results.(3)35-44 years old group(506 cases),there were 26.8%(136 / 506)cases with abnormal screening results.(4)45-54 years old group(447 cases),there were 34.6%(155 / 447)cases with abnormal screening results.(5)55-65 years old group(91 cases),there were 36.3%(33/91)cases with abnormal screening results.(6)>65 years old group(15 cases),there were 33.3%(5 / 15)cases with abnormal screening results.The abnormal detection rates of 45-54 years old group and 55-65 years old group were higher that other groups.The Characteristics of screening results at various age groups have shown that:(1)< 25 years old group(94 cases),there were 34%(32/94)cases with positive HPV,and no abnormal TCT.(2)25-34 years old group(461 cases),there were 26.9%(124/461)cases with positive HPV,and 2.2%(11/461)cases with abnormal TCT.(3)35-44 years old group(506 cases),There were 26.2%(133/506)cases with positive HPV,and 24.2%(35/506)cases with abnormal TCT.(4)45-54 years old group(447 cases),there were 32.8%(147/447)cases with positive HPV,and7.8%(35/447)cases with abnormal TCT.(5)55-65 years old group(91 cases),there were 32.9%(29/91)cases with positive HPV,and 11%(10/91)cases with abnormal TCT.(6)>65 years old group(15 cases),there were 33.3%(5/15)cases with positive HPV,and 13.3%(2/15)cases with abnormal TCT.The positive detection rates of HPV of < 25 years old group and >65years old group were higher than other groups.The abnormal detection rate of TCT was increased from 2.2%(25-34 years old group)to 13.3%(>65years old group)(?2=20.756,P<0.001).3)Comparison of cervical cancer screening results for different reasons for treatment have shown that:(1)Group A(1251 cases),there were 30.9%(387/1251)cases with abnormal tests.(2)Group B(167 cases): there were 32.9%(55/167)cases with abnormal tests.(3)Group C(196 cases): there were 22.4%(44/196)cases with abnormal tests.The abnormal rates of group A and group B were significantly higher that group C(P<0.05).The characteristics of screening results of cervical cancer have shown that:(1)Group A(1251 cases),there were 30.1%(377/1251)cases with positive HPV,and 4.4%(55/1251)cases with abnormal TCT.(2)Group B(167 cases): there were 31.1%(52/167)cases with positive HPV,and 10.7%(18/167)cases with abnormal TCT.(3)Group C(196 cases): there were 21.4%(42/196)cases with positive HPV,and 5.1%(10/196)cases with abnormal TCT.There was no significant difference between group A and group B(P>0.05).The positive rates of HPV of group A and group B were significantly higher than group C(P<0.05).The abnormal detection rate of TCT of group B was significantly higher than other groups(P<0.05).2.The correlation analysis between vaginal microecology and HPV tests in 1247 cases have shown that:1)There were 20.4%(255/1247)cases with normal vaginal microecology,50.0%(622/1247)cases with unbalanced vaginal microecology,and 29.6%(370/1247)cases with vaginitis.Moreover,there were 19.9%(248/1247)cases with bacterial vaginosis(BV),6.8%(85/1247)cases with vulvovaginal candidiasis(VVC),0.3%(4/1247)cases with trichomonal vaginitis(TV),and 2.6%(33/1247)with combined vaginitis.2)There were 21.8%(272/1247)cases with positive HPV,and 78.1%(975/1247)with negative HPV.(1)Positive HPV group(272 cases),there were 17.6%(48/272)cases with normal vaginal microecology,45.6%(124/272)cases with unbalanced vaginal microecology,and 36.8%(100/272)cases with vaginitis.(2)Negative HPV group(975 cases),there were 21.2%(207/975)cases with normal vaginal microecology,51.1%(498/975)cases with unbalanced vaginal microecology,and 27.7%(270/975)cases with vaginitis.The incidence rate of positive HPV group was significantly higher than that of negative HPV group(36.8% vs.27.7%)(?2=11.978,P=0.01).3)The comparison of HPV tests in different vaginal microecology have shown that:(1)There were 18.8%(48/255)cases with positive HPV in normal vaginal microecology group(255 cases).(2)There were 20.0%(124/622)cases with positive HPV in unbalanced vaginal microecology group(622 cases).(3)There were 29.8%(74/248)cases with positive HPV in bacterial vaginosis group(248 cases).(4)There were 22.4%(19/85)cases with positive HPV in VVC group(85 cases).(5)There were 21.2%(7/33)cases with positive HPV in combined vaginitis group(255 cases).The HPV positive rates of normal vaginal microecology group and unbalanced vaginal microecology group were significantly lower than that of BV group(P<0.05).Moreover,there was closely correlation between BV and HPV infection(P<0.05).Conclusion:1.The analysis of screening results of cervical cancer in 1614 women have shown that the age(<25 years old,and >65 years old)has correlation with HPV infection and abnormal TCT,and the incidence rate increase with age.Beside routine screening,the early symptoms and gynecological examination need to pay attention to as well.2.The vaginitis has relationship with HPV infection,and bacterial vaginosis is one of the high risk factors of HPV infection. |
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