| Objective:To investigate the necessity and condition of TCT normal HR-HPV positive patients and referring cervical biopsy under colposcopy.Methods:the 948 patients with normal TCT and HR-HPV positive were underwent cervical biopsy under colposcopy.according to the results of the examination,they were divided into chronic inflammation group,LSIL group and HSIL group.the correlation between each group and the medical institution level of HPV type,infection type number,patient age,delivery number,induced abortion number,cervical fluid-based cytology examination was analyzed.Results:1.Of the patients with normal TCT,328 HSIL occurred,or 34.6 per cent,of which 49.4 per cent(162/328)were from medical centres,20.4 per cent(67.328)were from provincial hospitals,22 per cent(72/328)and 8.2 per cent(27/328)were from county hospitals and municipal hospitals,respectively;the most sensitive TCT were provincial hospitals,82.4 per cent(313/380),and the lowest was 40 per cent.9 per cent(112/274);TCT sensitive at county and municipal hospitals sex was 60.9%(112/184)and 75.5%(83/110),respectively.2.The first five HR-HPV subtypes ranked as HPV 16?58?52?18?31 type;the HSIL groups were 328,34.6%;the distribution of HR-HPV types varied among the groups,the number of cases in HPV16?18?52?58 HSIL group was higher than that in chronic inflammation group and LSIL group,the difference was significant(P<0.05),and the number of cases in HPV31?33?35?39?45?51?56?59 group was lower than that in LSIL group and/or chronic inflammation group,the difference was significant(P<0.05)3.The number of infection HR-HPV groups was different in each group.The number of infection groups of two,three and more HR-HPV groups was higher than that of LSIL group and chronic inflammation group(P<0.05),and the number of infection groups of one HR-HPV type was lower than that of chronic inflammation group and LSIL group(P<0.05)4.Age distribution was different in each group.The number of HSIL groups aged 41-45,46-50 and 51-55 years was significantly higher than that of LSIL group and chronic inflammation group(P<0.05),and the number of HSIL groups aged<30,31-35,36-40 and 56 years was lower than that of LSIL group or chronic inflammation group(P<0.05)5.The number of natural births was different in each group,the number of natural births?1,the number of chronic inflammation group was higher than LSIL group LSIL group and HSIL group;The number of cases in the LSIL group 2-3 times of natural births was higher than that in the chronic inflammation group and HSIL group,and the number of cases in the HSIL group 3 times of natural births was higher than that in the chronic inflammation group and LSIL group,and the difference was significant(P<0.05)6.The number of induced abortion was different in each group,the number of induced abortion was<1 the number of chronic inflammation group was higher than LSIL group and HSIL group;the number of induced abortion 2-3 times LSIL group was higher than that of chronic inflammation group and HSIL group;the number of induced abortion>3 times was higher than that of chronic inflammation group and LSIL group(P<0.05)7.The HPV16?18?52?58 type,age 41-55 years old,number of deliveries>3 times,number of induced abortions 3 times,number of HR-HPV infection types 1 is related to cervical HSIL occurrence8.HPV16?18?58 type,age 41-55 years,number of deliveries>3 times,and number of induced abortions were independent risk factors for cervical HSILConclusion:1.Screening TCT cervical precancerous lesions alone has some missed diagnosis,combined with HPV screening can improve the detection rate of HSIL;2.The risk of occurrence HSIL of HPV 16?18 type is higher,but the risk of occurrence HSIL of non-16 and 18 type is higher3.Since the number of abortions>three times HPV16?18?58,41-55 years,the number of deliveries>three times and the number of abortions are independent risk factors for cervical HSIL,the need the need to refer to a vaginal biopsy for patients with normal HR-HPV positive for type HPV58,41-55 years of age,3 times of natural births and 3 times of induced abortions to reduce HSIL missed diagnosis can be further explored;4.If the sensitivity of physical examination center to TCT detection is lower than reasonable range,it is necessary to improve quality control. |
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