Evaluation Of The Screening Method And Study Of The Screening Strategy For Cervical Cancer

Objective: To evaluate the diagnostic value of screening methods and explore the optimal screening strategy for the detection of cervical cancer and precancerous lesions.Methods: A total of 1065 women who had taken cervical cancer screening and colposcopy cervical biopsy examination at the gynecological clinic of the First Hospital of Jilin University from October 2017 to June 2019 were enrolled.The distribution characteristics of HPV DNA types were analyzed.Using the histopathological results as the gold standard,evaluated the second-generation hybrid capture technology(Hybrid Capture-?,HC2),HPV DNA typing,HPV E6 / E7 m RNA,and liquid-based thin-layer cytology(TCT)of cervical shed cells and analyzed the relationship between the sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of the area under the receiver operating characteristic curve(ROC)of single and combined screening methods.Result: 1.In the smaller than HSIL group,the distribution characteristics of HPV DNA type were ranked according to the infection rate as HPV16(30.5%),52(14.8%),58(14.5%),18(14.1%),53(12.2%),51(9.9%),39(9.1%),56(7.6%),33(6.4%),66(6.1%),68(5.7%),59(4.1 %),31(3.8%),35(2.2%),45(0.7%).In the HSIL group,the HPV DNA type distribution characteristics were ranked according to the infection rate as HPV16(49.4%),58(12.5%),33(7.3%),31(7.3%),52(7.3%),18(5.6%),53(4.6%),35(2.3%),39(1.7%),66(0.9%),45(0.5%),59(0.5%),51(0.5%),56(0.5%),68(0.4%).2.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HPV16 were 60.0%,75.1%,53.8%,79.9%,and 0.678 respectively.The sensitivity,specificity,positive predictive value,and negative predictive value,and AUC value of HPV18 were 92.8%,11.8%,33.5%,27.6%,and 0.523 respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HPV31 were 50.0%,92.0%,61.5%,88.1%,and 0.711 respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HPV33 were 52.9%,90.0%,60.0%,88.1%,and 0.719,respectively.HPV31 and HPV33 had higher AUC values than HPV16 and HPV18.3.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HC2 were 95.0%,17.5%,21.9%,93.5%,and 0.563 respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HPV DNA typing were 94.8%,18.3%,35.7%,88.1%,and 0.566.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HPV E6/E7 m RNA were 76.1%,36.6%,27.3%,83.1% and 0.564.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of TCT were 76.5%,72.8%,49.2%,90.0% and 0.747.4.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HC2 + TCT were 71.7%,75.7%,41.0%,92.0%,and 0.738,respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HPV DNA typing +TCT were 76.9%,69.6%,54.5%,86.5%,and 0.733,respectively.The sensitivity,specificity,positive predictive value,negative predictive value,and AUC value of HC2 +HPVE6 / E7 m RNA + TCT were respectively 55.8%,81.9%,31.1%,92.7%,0.689.The sensitivity,specificity,positive predictive value,negative predictive value,AUC value of HPV DNA typing + HPVE6 / E7 m RNA + TCT were 61.2%,76.4%,56.4 %,79.9%,0.689.Conclusion: 1.HPV 16,31,33,35 infection rate increased with the increase of pathological grade,HPV 18,39,45,51,52,56,58,59,66,68 infection rate decreased with the increase of pathological grade.2.The AUC value of HPV31 and 33 was higher than that of HPV16 and 18.It was recommended to refer colposcopy directly in clinical work.3.In the single cervical cancer screening method,the diagnostic value of cytological detection was better than that of HPV detection.In the HPV detection method,HC2 and HPV DNA typing detection had high sensitivity,and HPVE6/E7 m RNA had high specificity.4.The diagnostic value of HPV DNA typing + TCT in the combined screening method of cervical cancer was the best,and it was currently suitable as a screening scheme for cervical cancer.