Research On New Technique And Biomarker For Cervical Cancer Screen

OBJECTIVE:To study the relationship between high risk human papillomavirus load and cervical lesion. And to investigate the value and clinical significance of multifunctional vinegar solution in the cervical cancer screening.METHODS:1. A Prospective study was carried on in 231 patients who were willing to have the cervical cancer screen in the PLA General Hospital during December 2014 and June 2015. All patients accepted TCT, HPV and folate receptor-mediated tumor detection. Histopathological examination was employed as "golden standard".2. Both HPV E6/E7 mRNA type and HPV DNA type were examined using Real-time quantitative PCR in 153 liquid-based cervical cytology samples. Histopathological examination was employed as "golden standard". OR, representing the risk of HSIL and cervical cancer, was calculated in type-specific HPV DNA positive group and type-specific HPV E6/E7 mRNA positive group.3. Immunohistochemistry was employed to detect FR and CREPT in 231 patients. In the mean time, Real-time quantitative PCR was also used to exam the expression of FR and CREPT in liquid-based cervical cytology samples. HPV E6 and E7 were transfected into C33A cell and the change of FR expression was evaluated.RESULTS:1. The mean age of women who have HSIL and cervical cancer is 40.15 ±8.03. The sensitivity of FRD is 77.53%, and the specificity of FRD is 55.63%. There is no significant difference observed between TCT and FRD. The diagnose accordance rate of FRD is 64.07%, significantly higher than that of TCT and HPV. The use of the smaller cotton swab of FRD decreases diagnostic efficiency. Compared with >ASCUS, difining abnormal TCT as>ASCUS has higher diagnostic efficiency. The negative predictive value of HPV is 100%. HC2 and HPV typing has no significant difference in sensitivity and the specificity.2. HPV 16 has the highest prevalence rate, followed by HPV52 and HPV58. The positive rate of HPV E6/E7 mRNA is related to the copied of HPV DNA. Type-specific HPV E6/E7 mRNA was effected by neither hrHPV nor lrHPV mixed infection. HPV 16 and 18 positive patients has a significantly higher risk to CIN2+. HPV E6/E7 mRNA positive patients are more likely to develop CIN2+than HPV DNA positive patients, especially for patients with HPV 16 and 18 E6/E7 mRNA positive.3. When immunohistochemistry is employed,, a significant low expression of folate receptor and CREPT in cervicitis and LSIL can be observed. And a significant higher expression of folate receptor and CREPT in HSIL and cervical cancer is shown. But there is no significant difference of folate receptor and CREPT mRNA detected in liquid-based cervical cytology samples from patients with different cervical lesions. And no FR expression change is observed in C33 A cell after HPV E6 and E7 were transfected.CONCLUSION:1. FRD and TCT have no significant difference in sensitivity and specificity. There is no significant difference between HC2 and HPV typing. The negative predictive value of HPV is remarkable.2. HPV E6/E7 mRNA positive patients are more likely to develop CIN2+ than HPV DNA positive patients, especially for patients with HPV 16 and 18 E6/E7 mRNA positive.3. Folate receptor and CREPT are significantly low expression in cervicitis and LSIL, and significantly higher expression in HSIL and cervical cancer. But there is no significant difference of folate receptor and CREPT mRNA detected in liquid-based cervical cytology samples from patients with different cervical lesions. No FR expression change is observed in C33A cell after HPV E6 and E7 were transfected. In the meanwhile, there is a slightly higher CREPT expression shown after HPV E7 and HPV E6/E7 were transfected.