| IntroductionCervical cancer represents the second most common cancer in women, with 465,000 new cases and 200,000 deaths worldwide every year. The universally accepted screening method for preventing cervical cancer is cytologic examination of cervical smears with papanicolaou staining ( Pap smear). The Pap smear allows the identification of lesions that are precancerous or cancerous.Well - organized, cytology - based screening programs for cervical cancer have been effective in reducing cancer incidence and preventing premature deaths. However, even in some countries in which screening programs have been pursued extensively for many years, cervical cancer has not been eradicated. One chief reason is the shortcomings of the technique itself, ie, the high frequency of false - negative results on the conventional Pap smear. Sensitivities of only 40% to 80% for high - grade cervical intraepithelial neoplasia ( CIN2 or CIN3) have been reported and reviewed by cuzick et al. And With the development of epidemiology and etiology, it has been demonstrated and well - accepted that HPV infection is the most common reason of cervical neoplasia.Recently, many concerns about the false - negative rates of conventional cervical cytologic testing have been noted. Because of these concerns, new technology has been developed, and some is already available, to enhance cervical cancer screening. But the efficiency of these new methods is still debatable. In our study, the liquid - based .cytology and HPV testing method are used in screening of precancerous or cancerous lesions to evaluate the screening efficiency (sensitivity, specificity, accuracy, positive predictive value and negative pre-dictive value) compared with the conventional Pap smear.Materials and methods1. Materials;The study population comprised 184 patients "with a mean age of 40. 3 (range!9 ~ 68) at the First Affiliated Hospital of China Medical University. Specimen collection was started in August 2002 and was completed in June 2003. Of the 184 patients recruited, 159 are outpatients, underwent colposcopy - directed biopsy; the other 25 are hospitalized patients received hysterectomy. All the 184 patients have histological diagnosis.2. Groups:A total of 184 patients are detected with the second - generation digene hybrid capture assay ( HC2 ) for detection of human papillomaviruses associated with high risk for cervical cancer. All the patients are randomly divided into 2 groups, 75 in conventional Pap smear (CV) group, and 109 in liquid -based cytology group. All detection is performed under blinded conditions.3. Collection and treatment of cytologic specimen;3.1. Conventional Pap cytology (CV) :Cells, collected with Szalay spatula from the endocervical canal as well as from the cervical surface simultaneously, were smeared on the slides, fixed in 95% alcohol for more than 15 min, then stained with the routine Papanicolaou staining.3.2. AutoCyte liquid - based cytology (AC) ; Cells, collected with special cervical sampler from the endocervical canal as well as from the cervical surface simultaneously, were washed into the vial filled with the AutoCyte preservation solution, processed with the AutoCyte Prep system, transported onto the slides, and automated Papanicolaou staining. This test was performed at the First Affiliated Hospital Pathology Center of China Medical University.4. Cytologic diagnosis; The reporting of both CV and AC diagnosis is according to the Bethesda System . ie:WNL( within normal limits) ;ASC - US (Atypical squamous cells of undetermined significance, ) ; LSIL ( Low grade squamous intraepithelial lesion ) ,which comprises cytologic abnormal associated with HPV and CIN1 ;HSIL(High grade squamous intraepithelial lesion) ,which comprises carcinoma in situ,CIN2 and CIN3; SCC ( squamous cell carcinoma) ; AGUS ( Atypical glandular cells of>undetermined significance) and adenocarcinoma. Squamous cell carcinoma and adenocarcinoma is called CA in my paper 05. High risk HPV DNA detection...
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