| Cervical diseases are the common and frequently encountered diseases of women, which include cervicitis, cervical intraepithelial neoplasia, cervical cancer and so on. Cervical cancer is one of the most common malignant tumor of gynecology, morbidity of which is the second in malignant tumor of gynecology, second only breast cancer. The genesis and development of cervical cancer is a slow and moderately advanced process, which also a process from qualitative alteration to gradual change. The process is usually continuous from cervical intraepithelial neoplasia (CIN I→II→III) to carcinoma in situ, from carcinoma in situ to early invasive carcinoma, from early invasive carcinoma to infiltrating carcinoma. Many studies have been done in cervical cancer, high risk type human papillomaviral infection is closed correlated to CIN and cervical cancer, which is the main factor of cervical cancer. The HPV infection rate is increased followd by aggravation of cervical diaeases. Therefore HPV test plays an important role in the examination of cervical diaeases. Reasonable and normative detection method is the key point of prevention and cure of cervical cancer.Objective: Through the study of HPV test combining with cytology and histology detections, to prove the relationship of HPV infection with cervical diseases, to identify genesis and development process of cervical cancer, to evaluate the clinical significance of HPV test in the detection of cervical diseases.Methods: All the cases involved in this study are the out-patients who received HPV test from May, 2007 to December, 2007 in Jilin university the first clinical hospital.According to the clinical sign and symptom of patients, doctors directed reasonable and normative detections, which included liquid based cytology, colposcopy, pathology detections. Liquid based cytology detection applyed for LPT system. Diagnostic standard was TBS (2001) classification system. HC2 test applyed for Digene corporation gene recombination signal amplification system. The result of test more than 1.0 was positive. Histopathology detection contained direct biopsy or biopsy by colposcopy. Histopathologic diagnosis was the gold diagnostic criteria. Statistics method: enumeration data used chi-squared analysis; measurement data used variance analysis.Results: 1,HPV testing outcome: 252 patients received this testing. HPV infection rate was 48.81%. The age distribution of patients was from 20 years old to 60 years old , divided the age into four groups: 20-29 years old, 30-39 years old, 40-49 years old, 50-60 years old. Through statistics analysis, P<0.05, difference existed statistical significance. HPV infection rate in 30-39 years old group was 56.64%, higher than other groups. 2,Liquid based cytology detection: 147 patients received this detection. NILM 95 cases (64.63%), ASC-US 13 cases (8.84%), ASC-H 2 cases (1.36%), LSIL 15 cases (10.20%), HSIL 20 cases (13.61%), SCC 2 cases (1.36%). There werenot abnormal glandular cells in all cases. Detection rate of abnormal cells was 35.37%. The age distribution of patients was from 21 years old to 57 years old, divided the age into four groups: 21-29 years old, 30-39 years old, 40-49 years old, 50-57 years old. Through statistics analysis, P>0.05, difference did not existe statistical significance. In this 147 cases, there were 75cases whose HPV test was positive, 72 cases whose HPV test was negative. Through statistics analysis, P<0.05, difference existed statistical significance. Except for ASC-H group, HPV infection rate was increased followd by raising of cytological grades. 3,Pathology detection: 93 patients received this detection chronic inflammation 26 cases (27.96%), low grade lesion 20 cases (21.51%), high grade lesion 44 cases (47.31%), invasive carcinoma of cervix 3 cases (3.23%). The age distribution of patients was from 21 years old to 55 years old, divided the age into four groups: 1-29 years old, 30-39 years old, 40-49 years old, 50-55 years old. Through statistics analysis, P<0.05, difference existed statistical significance. 30-39 years old group compared with 21-29 years old group the constituent ratio of low grade lesion and high grade lesion both decreased. The age of low grade lesion group compared with nvasive carcinoma of cervix group, Through statistics analysis, P<0.05, difference existed statistical significance. The difference of age between two groups were 9.03 years old. In this 93 cases, there were 69cases whose HPV test was positive, 24 cases whose HPV test was negative. Through statistics analysis, P<0.05, difference existed statistical significance. For high grade lesion and nvasive carcinoma of cervix, Sensitivity, specificity, positive predictive value, negative predictive value of HPV test respectively were 95.74%,47.83%,65.22%,91.67%. HPV infection rate was increased followd by raising of pathological grades. 80 cases received cytological, HPV and pathological detection, positive rate of low grade lesion in cytological and pathological detection respectively were 2.50%, 18.75%, compared with each other, P<0.05, difference existed statistical significance; Positive rate of high grade lesion in cytological and pathological detection respectively were 35.00%, 48.75%, compared with each other, P>0.05, difference did not existe statistical significance. For high grade lesion and nvasive carcinoma of cervix, Sensitivity, specificity, positive predictive value, negative predictive value of liquid based cytology detection respectively were 71.79%, 92.68%, 90.32%, 77.55%. HPV combining with liquid based cytology detection, detection rate of low grade lesion, high grade lesion and nvasive carcinoma of cervix respectively were 53.33%, 97.47%, 100.00%. Through statistics analysis, P<0.05, difference existed statistical significance. For high grade lesion and nvasive carcinoma of cervix, Sensitivity, specificity, positive predictive value, negative predictive value of HPV combining with liquid based cytology detection respectively were 97.44%, 53.66%, 66.67%, 95.65%.Conclusion: 1,High risk type human papillomaviral infection is closed correlated to cervical diseases, which is the main factor of cervical cancer. 2,The genesis and development of cervical cancer is an usual continuous process, from cervical intraepithelial neoplasia (CIN I→II→III) to carcinoma in situ, from carcinoma in situ to early invasive carcinoma, from early invasive carcinoma to infiltrating carcinoma. 3,HPV combining with liquid based cytology detection can decrease negative result of cytological detection, improve detection rate of cervical diseases, and have high diagnostic value for high grade lesion. 4,Reasonablely utilize HPV test and three-step- technique (The first step: cytology detection if conditionedly HPV combining with liquid based cytology detection; The second step: colposcopy detection; The third step: pathological detection.) and improve propaganda of the medical knowledge, which are the key points of prevention and cure of cervical cancer.
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