| Objective:To analysis the limitations and effectiveness of three screening methods: Thin Prep Cytologic Test(TCT),DNA ploidy analysis and Human Papilloma Virus(HPV)in cervical high-grade squamous intraepithelial lesion(HSIL)and cervical cancer detection.Methods:From June 1,2015 to May 31,2020,1232 cases of cervical high-grade squamous intraepithelial lesion(HSIL)and cervical cancer diagnosed by histopathology in Xiangxi Autonomous Prefecture People’s Hospital(The First Affiliated Hospital of Jishou University)with complete clinical data were collected.The retrospective analysis is based on the TCT,DNA ploidy analysis and/or HPV test results that is 1 year before the diagnosis.There were TCT test results(913 cases),DNA ploidy analysis results(490 cases),HPV test results(812 cases),and three combined test results(372 cases).The comparison of negative rates between the two groups was performed by chi-square test using statistical software SPSS26.0.When the predicted frequency was less than 5,Fisher’s exact test was used for analysis.Result:1.There are 1013 cases of cervical HSIL and 219 cases of cervical cancer histopathologically diagnosed among 1232 subjects.The cervical cancer histologies included squamous cell carcinoma(181cases),adenocarcinoma(31cases),and adenosqua-mous cell carcinoma(7 cases).2.There are 913 individuals had TCT in 1232 cases.The result indicated that 583cases(63.86%)with abnormal TCT results,330 cases(36.14%)with negative TCT results,and 53.03% inflammation was reported in the negative results of TCT.3.There are 490 patients had DNA ploidy analysis in 1232 cases,and 380 cases(77.55%)were positive,and 110 cases(22.45%)were negative.4.There are 812 cases were tested for HPV in 1232 cases.The HPV test was positive in 689 cases(84.85%)and negative in 123 cases(15.15%).The negative rates of squamous cell carcinoma,adenocarcinoma,and squamous adenocarcinoma were13.46%,37.50%,and 40.00%,respectively.The difference was statistically significant(P<0.05).The negative rates of HPV detection in adenocarcinoma and squamous cell carcinoma were compared with those in squamous cell carcinoma.The difference was statistically significant(Bonferroni correction,P<0.0167).The top five types of HPV positive rate were HPV16,58,52,33,and 18.The most common age group with positive HPV test is 40-50 years old(31.77%),followed by 50-60 years old(27.09%).5.There are 372 had TCT,DNA ploidy analysis and HPV test in 1232 cases.The negative rate of HPV detection(12.63%)was significantly different from that of TCT(23.12%)and DNA ploidy analysis(20.16%)(P<0.05).The positive rate of TCT+DNA ploidy analysis+HPV combined test was 94.09%,and the negative rate was 5.91%.The negative rate of TCT + DNA ploidy analysis + HPV(5.91%)was significantly different from that of HPV(12.63%),DNA ploidy analysis(20.16%),and TCT(23.12%)(P<0.05).)alone.6.The results of HPV,TCT and DNA ploidy analysis of 372 cervical HSIL and cervical cancer patients were divided into two groups.Compared with the ploidy analysis group(5.91%),the difference was statistically significant(P<0.05).Compared with the negative rate of HPV+TCT+DNA ploidy analysis group and TCT+DNA ploidy analysis group(5.91% vs 19.62%),the difference was statistically significant(P<0.05).Conclusion:1.HPV and(or)TCT and(or)DNA ploidy analysis alone or in combination to detect cervical HSIL and cervical cancer have partial negative results.HPV detection is combined with TCT detection or DNA ploidy analysis,or HPV+TCT+DNA ploidy analysis combined detection can effectively reduce the negative rate;2.In this study,the missed diagnosis rate of HPV in the detection of cervical HSIL and cervical cancer is lower than that of TCT and DNA ploidy analysis,which supports HPV detection as the main screening methods for cervical HSIL and cervical cancer;3.HPV detection combined with TCT or DNA ploidy analysis can be the first choice for cervical cancer screening in rural or economically underdeveloped areas. |
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