The Application Value Of High-risk Type HPV-DNA Testing In The Cervical Lesions Screening And Follow-up

Objective Cervical cancer is the most common malignant tumor in femalereproductive tract, and it seriously threat the health of women.A vast amount ofresearch worldwide shows that high-risk type human papillomavirus (HR-HPV)infection is a necessary conditions.Therefore, HR-HPV testing has played a veryimportant role not only in cervical cancer screening,but also in treatmentguiding,prognosis consideration and cervical cancers following-up visit.There iscurrently no evidence showing that HPV can cultivate in the organization cells,andno significant performance shows reproductive tract infection HR-HPV inserological.This drives the application of HR-HPV-DNA detection on thereproductive tract epithelial cells directly.According to the simplicity of operation,as well as the ability and capability of detecting HPV under various severities andvirus loads. Hybrid capture technology-II (HC2) is becoming the world’s mostwidely used methodology for HPV testing.In the study, used HC2method to test13type HR-HPV,in order to explore:1)The clinical values of HR-HPV testing incervical lesions of screening and follow-up visit;2)Through the HR-HPV testing incervical lesions,screening, the analysis of the distribution of HR-HPV in differentage groups,thereby discovering the relationships between HR-HPV virus load andcervical lesions degree.3)Through the evaluation of HR-HPV testing in cervicallesions follow-up visit and the analysis of HR-HPV load change after effectivetreatment, thereby setting up the links between pre-postoperative HR-HPV loadand the residual lesions or recurrent.Method This study was based on4301 patients(HR-HPV positive was838cases) who received HR-HPV testing in TheFirst People’s hospital in Yinchuan in2009,11-2011,04, including196cases ofpatients treated in our hospital and all patients accept at least12months follow-upvisit.The196cases all received LPT and histopathology test beforetreatment.HR-HPV testing was achieved by using Digene company production ofhybrid capture II(HC2), the virus load was represented by unit of RLU/CO.Result1) The LTP abnormal rate in CIN and cervical invaded cancer was significantlyhigher than the cervicitis(P﹤0.000).The HPV positive patients with LPT normalor abnormal diagnosis as CIN were69.31%and18.88%respectively (P﹤0.000).The HPV positive patients with LPT normal or abnormal diagnosis as cervicalinvaded cancer were11.64%and0.50%respectively(P﹤0.000).2)HR-HPVpositive rate in20-29,30-39,40-49,50-59,and>60years old group were21.83%,18.63%,18.14%,20.66%and21.08%,respectively; CIN II and above in theincidence of lesions separately were17.56%,40.84%,40.98%,26.14%and66.67%; Patients within30-39years were shown to have similar incidenceoutside with40-49patients (P>0.05), but higher incidence than20-29years oldand50-59years groups(P <0.05).3) HR-HPV-DNA load in cervicitis group wassignificantly lower than the cervical cancer group and CIN group; However, Thereis no significant difference between cervical cancer group and CIN group in termsof HR-HPV-DNA load as well as the in CIN groups among all level（s P>0.05）.4)Inthe follow-up visit,the HR-HPV-DNA load were significantly reduced witheffective treat in196cases of patients after6and12months（P<0.05).TheHR-HPV negativity with respect to CINI, CIN Ⅱ, CINIII and cervical cancergroup are95.1%and87.2%,86.6%, and74.3%after6months, and97.22%and89.83%and85.71%and78.26%after12months.After6months and12monthsthe total negativity was87.75%and90.30%. The negativity was100%with no patient after surgery has recurred.5)By dividing the HR-HPV-DNA loads (RLU/CO)into for intervals(i.e.1-10,10-100,100-1000and1000, respectively), theHR-HPV-DNA load distributions of196patients who received the treatmentspreoperatively were23.47%,39.80%,29.59%, and7.14%,respectively.HR-HPADNA loads were mainly scattered in the level between10and1000.However, the follow-up process we found that the residual lesions orrecurrence rate respectively for10.86%,12.82%,12.07%,14.28%, did not showobvious difference(P>0.05）.6） After treatment, the cutting edge positive grouphave higher lesion residue or the recurrence rate than the negative groups(57.89%compare with1.27%). And the HR-HPV continuous positive group havesignificantly higher lesion residue or the recurrence rate than the HR-HPVnegative group(38.71%compare with0.00%). Conclusion In the cervicallesions,screening,there exists a certain mis-diagnosis while using the LPTindividually,whereas the combination of LPT and HPV testing in cervicallesions-screening showed improvement of the diagnosis performance.The objectwho should take HPV test according to different regions of the economicconditions and different individual sex life situation.The highest incidenceoccurred in the participants with ages between20and49years,but30to49agehave both high HPV infection rate and high CINII and above disease incidencerate.In the cervical lesions,screening the high HPV-DNA load do not means theseverity of the disease,what,s more, should not use the HPV-DNA load to forecastthe lesions recurrence or residual incidence rate after treatment. In addition, fordifferent levels of cervical disease should adopt operation,which helpful with turnHPV to negative. Constant HR-HPV infection is a independent risk factor in thelesions recurrence or residual incidence rate after treatment,and it,s a goodprediction with HPV monitoring in the lesions recurrence or residual incidence rate after treatment.