| Objective The purpose of this study was to explore the role of the human papillomavirus genotyping detection and thinprep cytologic test inspection in the diagnosis and treatment of cervical high-grade squamous intraepithelial lesions,to explore whether HPV52/58 can be used as indicators of referral colposcopy,and to explore whether the results of HPV genotyping detection(16/18/52/58)and thinprep cytologic inspectiontest can be used as objective indicators index to predict the lesions upgrades and residual lesions after conization of cervix,to provide objective basises for diagnosis and treatment of cervical high-grade squamous intraepithelial lesions.Methods The complete cervical cytology,HPV detection and pathological data of 249 patients were collected serviced by gynaecology clinic of the Tianjin First Central Hospital from January 1,2010 to April 31,2016 were collected.The HPV detection method is the diversion hybridization technique.Results1.HPV infection rate was 90.76% in this study.The single subtype high-risk HPV infection rate was 64.65%,and the multiple subtypes high-risk HPV infection was 22.49%.The most common high-risk genotypes were HPV16,58,52,18,33.2.HPV infection rate was highest in 20 to 30 years old group(97.30%);followed by the 41 to 50 years old group(92.59%).3.Pathological diagnosis was CINⅠ45 cases,CINⅡ-Ⅲ 194 cases,Cervical invasive carcinoma 2 cases.The infection rate of HPV16/18 in HSIL group was higher than that in LSIL group(X~2=9.001,p<0.05).The infection rate of other HPV subtypes in HSIL group was lower than that in LSIL group(X~2=6.773,p<0.05).The infection rate of HPV52/58 in HSIL group was higher than that LSIL group(X~2=5.530,p>0.05).4.In abnormal cervical cytology results,Pathological diagnosis was CINⅠ45 cases,CINⅡ61 cases,CINⅢ 133 cases,Cervical invasive carcinoma 2 cases.TCT results between cervical lesions at all levels(X~2=30.311,p<0.05).5.TCT for HSIL had a higher incidence of cervical lesions than LSIL(X~2=18.186,p<0.05).6.HPV16/18,HPV52/58,other HR-HPV subtypes,HPV16/18 infection patients had a higher incidence of HSIL than other HR-HPV subtypes(X~2=5.282,p<0.05).HPV52/58 infection,HPV16/18 infection and other HR-HPV infection(X~2=0.051,p>0.05;X~2=3.551,p>0.05).7.TCT for HSIL had a higher incidence of cervical margin positive than LSIL(X2=8.129,p<0.01).8.There are differences between HPV16/18,HPV52/58 and other HR-HPV subtypes infection of margin positive,but there was no statistically significant(X~2=1.025,p>0.05).9.TCT for HSIL had a higher incidence of pathological grade increased after conization than LSIL(X~2=6.074,p<0.05).10.There are differences between HPV16/18,HPV52/58 and other HR-HPV subtypes infection of pathological grade increased after conization,but there was no statistically significant(X~2=0.861,p>0.05).Conclusions1.The infection rate of HPV increased with the level of cervical lesions increased.2.The distribution of HPV infection rate and infection subtypes were distribution of regional different differences: HPV16/18/52/58 were the main types of cervical lesions in the region,HPV16/18 can be used as indicators of referral colposcopy,but HPV52/58 can not be used as indicators of referral colposcopy.3.HPV infection age distribution has two peaks: 20 to 30 years old of young female HPV infection rate is the highest,41 to 50 years old perimenopausal female appear the second peak.4.TCT for HSIL predicts cervical HSIL sensitivity and specificity were superior to different types of HR-HPV infection.The sensitivity of HSIL to predict the conization margin positive and pathological grade increased after conization was better than that of different types of HR-HPV infection.Therefore,in the diagnosis and treatment of cervical lesions,we should pay more attention to the results of cervical cytology,especially HSIL. |
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