Studies On Human Papillomavirus-testing In Routing Cervical Cancer Screening

Part Ⅰ Study of the correlation between cervical cancer and human papillomavirus infectionObjective: To prove the correlation between human papillomavirus (HPV)infection and cervical cancer.Methods: 115 paraffin-embedded specimens were enrolled, including 31specimens with invasive carcinoma,28 specimens with high grade cervicalintraepithelial lesion(CIN Ⅱ -CIN Ⅲ),21 specimens with low grade cervicalintraepithelial lesion(CIN Ⅰ ),35 specimens with inflammation .HPV 16/18 PCRwas performed on these specimens.Result: The overall prevalence of HPV 16/18 was 26.96%,14.29% withinflammation ,14.29% with CIN Ⅰ ,39.79% with CIN Ⅱ-CIN Ⅲ,38.71% withinvasive carcinoma. Significant differences between groups, especially betweeninvasive carcinoma and inflammation, CIN Ⅱ-CIN Ⅲ and inflammation. Therewas no difference between CIN Ⅰ and inflammation.Conclusion: HPV 16/18 is the principle risk factors associated with cervicalcancer.Part II Studies on HPV-testing in Routing Cervical Cancer ScreeningObjective: To go step further to prove the correlation between HPV infections and cervical cancer, and evaluation the significance of HPV testing in diagnose and treatment and prognoses of cervical cancer.Methods: 1231 women were tested TCT and HPV DNA.131 specimens were performed colpscopies multiple biopsies, including abnormal cytological screen test tissue, normal but highly suspected abnormality in clinics and normal but HPV DNA ( + ) tissue, we carry on analysis according to the pathological results. Results: TCT results: normal (1077/1231 87.43%),ASCUS (32/1231 2.60%),ASCUS-H(34/1231 2.76%), LSIL(73/1231 5.93%), HSIL(15/1231 1.22%).The pathological results: inflammation (68/131 51.91%), CIN I (20/131 15.27%),CIN II (18/131 13.74%),CINIII16/131 .21%), invasive carcinoma (4/131 4.35%), condyloma (5/131 3.82%). The overall prevalence of HPV infection was 33.96%. HPV was detected in 58.82% of inflammation, 80% of CIN 1,72.22% of CIN II, 100% of CINlII,100% of invasive carcinoma, 60% of condyloma. HPV infection of low grade lesion group (^CIN I ) was 63.44%(59/93),high grade lesion group (^ CIN II) was 86.84% (33/38),there was significant difference between them, P<0.01. Compare the symptom and cervical sign between two groups, there was no difference between symptoms of two groups. There weren't high grade lesion in these specimens whose TCT and HPV were negative, TCT (—) and HPV (+ ) , 11.1% (1/9) high grade lesion were found, TCT ( + ) and HPV (+) , 40.75%(32/79), TCT ( +) and HPV (—),13.2% (5/38), all were CIN II, no carcinoma in site and no invasive carcinoma was detected. Sensitivity (Se) of coloscopy based on TCT and HPV testing for the detection of high grade lesion (^CINII) was 0.73, Specificity (Se) was 0.93, positive predictive value (PPV) was 0.82, negative predictive value (NPV) was 0.89, J was 0.66, Kappa was 0.66.