The Value Of P16^INK4aExpression By Fluorescence In Situ Hybridization In Triage For High Risk HPV Positive In Cervical Cancer Screening

Cervical cancer is the second most common malignancy in women worldwide, and it severely threaten women's life and health. The carrying out of the cervical cancer screening program had remarkably reduced its morbidity and mortality. Cytology test have been used in the cervical cancer screening for 50 years due to its high specificity, however, cytology test which mainly depend on the change of cells can be affected by so many factors thus lead to a high false negative rate, women suffering from the disease missed the good opportunity for early diagnosis and treatment because of this. After the establishment of HPV as the etiology of cervical cancer, the development of cervical cancer screening was largely promoted by the test of HPV DNA. It was reported that almost all the cervical cancer and most of the precancerous were infected with high risk HPV. HPV DNA test, as a primary screening tool, has been applied in some areas of the world including China currently. The infection rate of HPV is high in the health women, a lot of them were a transient infection especially those with active sexual activity, infection can regress within a period, thus how can we detect those real patient from the infection crowd was of important clinical significance. In HPV-based screen strategy, cytology is an alternative triage method for high-risk HPV positive women, the sensitivity of cytology remains to be elevated, Therefore, a more accurate and sensitive assay, besides cytology, is expected for the triage for women with high-risk HPV positive.The identification of markers that link high-risk HPV infection with molecular changes that occur in the neoplastic process could theoretically increase sensitivity and specificity for detection of cervical disease. Basing on studies published so far, pl6ink4a could potentially be used as such a marker. Iimmunostaining is the most common technique for p16ink4a detection in previous studies, and its main shortcoming is subjective. In the study, we detected P16ink4a by fluorescence in situ hybridization (FISH) in high-risk HPV positive cervical samples was more sensitive, more reproducible and less subjective, and explore the possibility for triage of the high risk HPV positive women.Objective:The aim of this study is to evaluate the effect of fluorescence in situ hybridization (FISH) detection for pl6ink4a expression as an alternative triage for high risk HPV positive women in cervical cancer screening.Methods:Totally 191 cervical cell specimens from women with HPV positive were collected. The pl6ink4a expression by FISH and liquid-based thin-layer cytology were performed and followed by colposcopy with or without biopsied histologic examination for all participants. The relationship between pl6ink4a expression and histologic diagnosis, as well as cytology and viral load, was analyzed.Results:The positive rate of pl6ink4a was 5.35% in normal or inflammation cases, 56.67% in CIN 1,83.78% in CIN 2-3,100.00% in carcinoma, respectively, with a significance between