| ObjectiveTo study the relationship between different grades of cervical lesions and HPV infection,TCT levels as well as P16 protein expression,to compare the diagnostic efficacy of HPV,TCT and P16 for cervical lesions,to explore the effectiveness and appropriateness of the three methods used alone or in combination in the clinical diagnosis of cervical lesions,as well as to provide relevant supporting data for the screening of cervical precancerous lesions.MethodsA total of 580 patients with complete cervical exfoliation cytology and HPV detection and pathological data who underwent cervical cancer screening in the outpatient department of obstetrics and gynecology of Qilu Hospital of Shandong University were collected,from January to June 2019.HPV detection was performed by polymerase chain raction（PCR）,and pathological results included mmunohistochemical P16 detection.Statistical Methods:The differences of HR-HPV and TCT≥ASCUS in addition to P16 expression among different levels of cervical lesions were tested by chi-square test,and P<0.05 in the statistical results was considered to have significant differences.Sensitivity（SE）,specificity（SP）,positive predictive value（PPV）,as well as negative predictive value（NPV）were utilized to describe the accuracy of the detection methods in the diagnosis of advanced lesions and cervical cancer.Results1.548 cases were HPV positive among the 580 cases of which the positive rate for HPV was 91.14%in the hiopathological inflammatory group,and the positive rate in CINⅠ,CINⅡ,CINⅢ and cervical cancer increased successively from 96.13%to 96.85%,100%and 100%.2.A total of 235 cases were detected of TCT≥ASCUS positive,of which the detection rate of TCT≥ASCUS in the inflammatory group was 28.27%,additionally the detection rates of CINⅠ,CINⅡ,CINⅢ and cervical cancer increased to 39.35%,52.76%,62.75%and 80%significantly.3.A total of 208 cases was positive for P16,of which the positive rate of P16 in the inflammatory group was 0,with the successively increased positive rates of P16 in CINⅠ,CINⅡ,CINⅢ and cervical cancer by 16.13%,95.28%,100%and 100%.4.The diagnostic performances of cervical lesions using the three methods of HPV,TCT and P16 were compared in this study.As for HPV,the test sensitivity,specificity,positive predictive value and negative predictive value were 96.8%,8.9%,60.6%and 65.6%correspondingly,and as for TCT,the above four diagnostic performance indicators were 49.0%,71.7%,71.5%and 49.3%,for P16,the above four values were 60.3%,100%,100%and 63.5%,for the combined method of P16 and TCT+HPV,the above four diagnostic performance indicators were 99.4%,2.1%,59.5%and 71.4%.P16 combined with TCT+HPV for cervical lesion screening had both high sensitivity value and good negative predictive value for the detection of abnormal cervical lesions.5.The positive rate was 49.37%（39/79）in the ≤30 years group,38.25%（140/366）in the 30-50 years group and 21.48%（29/135）in the≥50 years group.Age was an important factor affecting P16 expression.6.In TCT groups of all grades,the number of positive P16 expression were 91,70,34,11,1,and the positive rates were 26.38%,50.72%,42.5%,73.33%,100%.The positive rates among groups at all levels ware statistically significantly different（X2=39.28,P<0.01）Conclusion1.HPV infection is closely related to cervical lesions,and 97%cervical lesions have HPV infection.2.TCT combined with HPV detection method has a higher detection rate for the detection of cervical lesions.3.The positive rate of P16 protein expression was positively correlated with the degree of cervical lesions.4.P16 combined with TCT+HPV screening is more helpful to determine the lesion level of CIN and provides a basis for individualized treatment. |
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