Application Value Of Folic Acid Receptor-mediated Diagnosis (FRD) For Cervical Cancer Screening

Objective: We investigated the clinical significance of folic acid receptor-mediated diagnosis(FRD)by comparing the effectiveness of FRD with thinprep cytologic test(TCT).Methods: We selected the gynecological outpatients of the second hospital of Jilin University from November 2018 to September 2019 for TCT,HPV-DNA and FRD screening.After screening,the patients with cervical lesions(in line with the conditions of colposcopy referral)were proposed to be diagnosed,and additional colposcopy cervical biopsy was carried out.Patients were examined by endocervical curettage if FRD examination showed that cervical canal lesions or AGC cytological results.The clinical diagnostic value of FRD and TCT were compared using cervical biopsy pathology as the diagnostic gold standard.Results: 1.A total of 308 cases were included.The age of the subjects was 21-67 years,the average age was 40.53 ± 10.74 years,and the median age was 40 years.TCT showed a total of 148 cases(48.05%),including 84 ASCUS(27.27%),10 ASC-H(3.25%),36 LSIL(11.69%),16 HSIL(5.19%),and 2 AGC(0.65%).FRD examination showed a total of 148 cases(48.05%)of which were positive,of which 148 cases(48.05%)were positive for cervical mouth staining and 30 cases(9.74%)were positive for cervical canal staining.Cervical biopsy pathology results: 142 cases of cervicitis or normal(46.10%),92 cases of LSIL(29.87%),64 cases of HSIL(20.78%)and 10 cases of cervical cancer(3.24%).2.Pathological examination for lesions above HSIL as a positive criterion.The sensitivity,specificity,and accuracy of TCT in the diagnosis of cervical lesions were 67.57%,58.12% and 60.39%,respectively.The positive predictive value(PPV)and negative predictive value(NPV)were 33.78% and 85.00%,respectively.The Kappa value of consistency test was 0.19.The sensitivity,specificity and accuracy of FRD in the diagnosis of cervical lesions were 72.97%,59.83% and 62.99%,respectively.The PPV and NPV values were 36.49% and 87.50%,respectively.The Kappa value of consistency was 0.24.Conclusions: 1.The diagnostic consistency of FRD,TCT and biopsy pathology was poor,Kappa values were all lower than 0.40.2.Compared with TCT,the sensitivity,specificity,accuracy and consistency of FRD were slightly better,but the results were not statistically significant.3.Although FRD detection technology has its own limitations,it has certain advantages and application prospects in the screening of cervical intraepithelial neoplasia,especially in the underdeveloped areas lacking of cytopathologists.