The Value Of High-risk Hpv Detection In Cervical Lesions

Objective:To evaluate the significance of high-risk human papillomavirus(HR -HPV) DNA testing in diagnosis of cervical lesions.Methods:A total of 720 cases had liquid-based cytology test and HR-HPV DNA testing by hybrid captureⅡ,in which 224 cases received cervical biopsy because of abnormal cytology(≥ASC-US).Then we analyze the result of pathological result.Results:1.The overall prevalence of HPV infection was 36.7%.246 patients were HPV positive with the mean age of 37.77±8.48,while 456 patients were HPV negative and their mean age was 39.25±8.83;the former was significantly younger than the later(P＜0.05).In HPV positive groups there were 64 cases between 21and 30 years old,98 cases between 31 and 40,88 cases between 41 and 50 and 14 cases between 51 and 60, respectively.2.In the 224 cases,the rate of high-grade cervical lesions were 45.1%(101/224) and 52.1%(87/167) in people with abnormal cervical cytology above ASC-US and LISL, respectively.The rate was increased with aggravation of cervical cytology(P＜0.05).3.The rates of HPV infection were 12.3%(61/496) in normal and inflammatory cytology,,63.2%(36/57) in ASC-US,75.0%(12/16) in ASC-H,83.9%(76/87) in LSIL and 91.1%(47/56) in HSIL.The rate was increased with aggravation of cervical cytology changes(P＜0.01).4.In the 224 cases,the rates of HPV infection were 64.9%(61/94) in chronic cervicitis and tratified squamous epithelia papillomatous hyperplasia,82.8%(24/29) in CINⅠ,89.7%(26/29)in CINⅡ,93.5%(58/62) in CINⅢand 100%(10/10) in invasive cervical cancer.The rate was increased with aggravation of cervical histology changes(P＜0.05).5.High risk HPV DNA load increased with aggrevation of cervical diseases and there was significant correlation(H=11.3429,P=0.0450.The load was a little higher in CINI.There were no signiticant diferences of high risk HPV load between any two groups.6.Among 57 patients with abnormal cervical cytology of ASC-US,the rate of high-grade cervical lesions was 24.6%,and it was higher in HPV positive group(33.3%)than in HPV negative group(9.5%)(P＜0.05).There were no CINⅢand invasive cervical cancer in HPV negative group.7.Among 87 patients with abnormal cervical cytology of LSIL,the rate of high-grade cervical lesions was 34.5%,which was even higher in HPV positive group(39.5%)than in HPV negative group(0%)(P＜0.01).Conclusions:1.High-risk HPV DNA testing palys an important clinical significance in precicting cervical diseases.Persistent HPV infection indicates the exists of cervical diseases and is a Latency of developing into high-grade cervical diseases and cervical cancer.2.High risk HPV DNA load increased with aggrevation of cervical diseases.There is significant corelation between elevated high risk HPV DNA load and severity of cervical lesion.3.High-risk HPV DNA testing can help improve detection rate of high-grade cervical lesions in patients with cytology of ASC-US,greatly reducing the rates of Colposcopic biopsy and loss of patients because of long-term fllow-ups.4.High-risk HPV DNA testing can help improve detection rate of high-grade cervical lesions in patients with cytology of LSIL.If economy permits,patients with cytology of LISL should receive HPV DNA testing first.