Study On The Effectiveness Of DH3 HPV Detection Combined With TCT In The Evaluation Of Cervical Lesions

Objective:The purpose of this study is to explore the correlation between DH3 HPV detection in low-grade cervical lesions and high-grade cervical lesions,and the degree of lesions,to determine whether the HPV load increases with the severity of cervical lesions.According to the research results,the reliability and sensitivity of the DH3 detection technology for the diagnosis of cervical lesions can be judged,so as to determine whether the method can be used as an auxiliary diagnosis for clinical monitoring of cervical lesions.Methods:Retrospective statistics from August 2017 to May 2019 in the Shenyang Women’s and Children’s Hospital,aged 25-65 years old with a history of sexual life or sexual behavior,and no vaginal medication,no vaginal lavage within three days,A total of1213 cases of asexual patients who were voluntarily screened underwent Cobas 4800 HPV testing and TCT combined screening,and DH3 HPV testing was performed on the specimens at the same time.A colposcopy biopsy was performed on patients with abnormal TCT and/or abnormal Cobas 4800 HPV detection.From this sample,591 patients with biopsy pathological results were counted.In this study,three statistical methods,correlation analysis,rank sum test analysis,and ROC curve were used.Pathological results were used as the gold standard to study the effectiveness of DH3 HPV detection in evaluating cervical lesions from different perspectives.Results:1.In the correlation analysis,the correlation coefficient between cervical lesion grade and HPV load of 16 and 18 is 0.326(P<0.05),the correlation coefficient of other12 types of HPV load is 0.208(P<0.05),cervical lesion grade It is positively correlated with the quantitative detection value of DH3.In the pathological group,the medians of16 and 18 HPV loads of chronic cervicitis,LSIL,HSIL and cervical cancer and the other 12 types of HPV loads were statistically significant(P<0.01).2.In the rank sum test analysis,3 samples of cervical cancer were excluded.The analysis results of 588 samples showed that no matter the 16 and 18 HPV loads or the other 12 HPV loads,they were all in the different lesion grades of chronic cervicitis,LSIL,and HSIL.There are differences,and the differences are statistically significant(P<0.05).Using pairwise comparisons,16 and 18 HPV loads were statistically different in the three lesion grades(P<0.05).As the viral load increased,the lesion grades were higher.According to the results of TCT,588 samples were divided into NILM group for TCT,ASC-US group for TCT,and LSIL group for TCT≥LSIL.In these three groups,16 and 18 HPV loads are in the different grades of chronic cervicitis,LSIL,and HSIL.There are differences,and the differences are statistically significant(P<0.05).The other 12 types of HPV load in the TCT≥LSIL group had no difference in different lesion grades.The three cervical lesion levels were compared in pairs.In the TCT group NILM,16 and 18 HPV loads were different between chronic cervicitis and LSIL,and chronic cervicitis and HSIL groups,and the difference was statistically significant(P<0.05);TCT is the ASC-US group,16 and 18 HPV loads are different between chronic cervicitis and HSIL,LSIL and HSIL groups,the difference is statistically significant(P<0.05);in the TCT≥LSIL group,16 and 18 HPV loads are between There were differences between chronic cervicitis and HSIL,LSIL and HSIL groups,and the difference was statistically significant(P<0.05).TCT is the NILM group,the other 12 HPV loads are statistically significant in chronic cervicitis and LSIL components(P<0.05);TCT is the ASC-US group,the other 12 HPV loads are in chronic cervicitis and LSIL,chronic There was a difference between the cervicitis and HSIL groups,and the difference was statistically significant(P<0.05).3.In the ROC curve analysis,in the full sample of 591 cases,16 and 18 HPV loads can predict pathological results with the other 12 HPV loads.At the same time,16 and18 HPV loads are different from the other 12 HPV loads.16 and 18 HPV load prediction effect is better.When TCT is NILM,HPV load of types 16 and 18 can predict pathological results,with a predictive value of 0.245 pg/m L.If the cut-off value is greater than or equal to 0.245 pg/m L,the test result is more likely to be a high-grade disease;TCT is In ASC-US,the HPV load of types 16 and 18 can predict the pathological test results.If the cut-off value is greater than or equal to 0.285pg/m L,the test result is likely to be high-grade lesions;when TCT≥LSIL,the HPV load of 16 and18 can predict pathology According to the test result,if the cut-off value is≥1.21pg/m L,the test result is likely to be high-grade lesions;the other 12 types of HPV load have no effect on the prediction of pathological test results in the group.Conclusion:In the DH3 detection technology,the 16 and 18 HPV loads and the other 12 HPV loads are correlated with cervical lesions.According to the analysis of rank sum test results,16 and 18 HPV loads are different in different cervical lesion grades(chronic cervicitis,LSIL and HSIL),and the difference is statistically significant.It can be considered that the higher the 16 and 18 HPV loads,the higher the cervical lesions.The higher the lesion grade,however,the other 12 types of HPV load have no statistically significant difference among different cervical lesion grades.The effectiveness of the other 12 types of HPV load in assessing cervical lesions needs to be further studied.The ROC curve results proved that among the 591 full samples,the 16 and 18 viral loads and the other 12 viral loads have a certain predictive effect on high-grade cervical lesions,and the 16 and 18 viral loads have a better predictive effect.But in the three groups of TCT,that is,when TCT is NILM,when TCT is ASCUS,and when TCT≥LSIL,HPV loads of types 16 and 18 have predictive effects on high-grade cervical lesions,while the other 12 types of HPV The forecasting effect of loading capacity needs to continue to increase the number of samples to confirm the research.Whether DH3 test combined with TCT test can be used as a screening index to predict highgrade cervical lesions needs to be further confirmed.