The Value Of HPV Typing In The Diagnosis Of Cervical Lesions

Objective:To analyze the HPV infection in our hospital’s opportunistic screening population and patients with cervical lesions,summarize the hr-hpv infection and classification in our hospital,and explore the value of HPV typing in the diagnosis of cervical lesions.Methods: Retrospective analysis was performed on the data of 18714 patients who underwent opportunistic screening in the outpatient department of obstetrics and gynecology of our hospital from January 2017 to June 30,2019.Statistical analysis was performed on the HPV infection rate,type distribution and infection trend of the above population in our hospital by using Excel sheets and SPSS software.And analysis on January 1,2017-June 30,2019 in our department outpatient service line of cervical biopsy under colposcope or cervical LEEP operation,and the histologic diagnosis of cervical low level intraepithelial lesions(LSIL),high level cervical intraepithelial lesion(HSIL)and cervical cancer(CC),and preoperative half year adept 1315 patients of detection of HPV types of HPV infection status,analyze different cervical lesions in the fractal characteristics of high-risk type HPV infection.Results:1.Among the 18,714 screening cases,there were 4,825 HPV positive cases,the HPV positive rate was 25.78%,the total positive number of HPV was 6,986(multiple infection double count),and the hr-hpv positive number was 4,603.High risk HPV infection 65.89%(4603/6986),low risk HPV infection 33.41%(2334/6986).The top 7 hr-hpv genotypes were HPV16(16.16%),HPV52(12.84%),HPV58(8.52%),HPV53(5.58%),HPV51(4.22%),HPV56(4.05%),and HPV18(3.26%).The top five LR-HPV genotypes were HPV42(4.27%)、HPV44(4.02%)、HPV68(3.81%)、HPV40(3.75%)、HPV61(3.22%).2.Among the 1315 patients with cervical lesions confirmed by hiopathology,1142 were infected with HPV,with a total infection rate of 86.84%.The top five high-risk HPV infections in LSIL patients were HPV52,HPV16,HPV58,HPV51,HPV33,HSIL patients were HPV16,HPV52,HPV58,HPV18,HPV31,and CC patients were HPV16,HPV18,HPV52,HPV58,HPV33,respectively.The infection rates of HPV in LSIL group,HSIL group and CC group were 76.85%(405/527),92.60%(613/662)and 98.41(124/126),respectively.3.Taking the pathologic diagnosis of cervical lesions as the gold standard,the sensitivity,specificity,positive predictive value and negative predictive value of HPV typing in the diagnosis of highly cervical lesions were 93.53%,23.15%,64.54% and 70.52%,respectively.The OR value is 1.50.Conclusion: 1.The cervical infection rate of women in the obstetrics and gynecology outpatient department of our hospital was high(25.78%),with high-risk HPV infection taking the leading position.The top 7 hr-hpv genotypes were HPV16,HPV52,HPV58,HPV53,HPV51,HPV56,and HPV18.The top five LR-HPV genotypes were HPV42、HPV44、HPV68 、HPV40、HPV61。 2.The severity of cervical lesions is closely related to the infection of high-risk HPV,mainly including HPV16,HPV52,HPV58,HPV33,HPV18 and HPV31.For the above infected people,they should be regarded as high-risk groups,and they can be transferred to colposcopies in time.3.HPV typing test has a very high sensitivity to the diagnosis of cervical lesions,with a high positive predictive value and a high negative predictive value,which is of great significance in the layered management of cervical lesions.Patients who were positive for HPV typing were 1.5 times more likely to develop high levels of intraepithelial lesions than those who were negative for HPV typing.