The Clinical Application Value Of HPV-DNA Testing Combined With Tct In Diagnosis And Follow-UP In CINⅡ-Ⅲ

Objective:To investigate the human papillomavirus (HPV) infection of the high-grade cervical intraepithelial neoplasia (CIN), and evaluate the clinical application value of HPV testing combined with TCT in diagnosis and predict residual/recurrent in patients treated for CIN Ⅱ-Ⅲ.Methods:71cases of CIN Ⅱ-Ⅲ in the tumor hospital affiliated Guangxi Medical University between August2010with August2013were studied. All the patients were tested HPV and(or) cytology with HybriMax and thinprep cytologic test during pre-operation to post-operation follow-up visit. Compared with the detective result and patholoty, analysis the relation between the HPV, TCT and diagnosis, prognosis in CIN Ⅱ-Ⅲ patients.Results:(1).The total positivity rate of HPV in patients with CIN Ⅱ-Ⅲ was93.33%(56/60). single rate was75.00%, and the multiple rate was18.33%. there was no statistically significant difference between CIN grades and HPV infection (P=0.538). The prevalence of different HPV types from highest to lowest order were HPV16(62.50%), HPV58(23.21%),HPV33(14.29%),HPV52(12.50%),HPV31(7.14%).(2). The pre-operation cytologic detection rate was85.45%(47/55). There was no statistically significant difference between CIN grades with cytologic detection rates.(3). HPV, TCT, HPV co-TCT for the predetermination of CINⅡ-Ⅲ sensitivity were91.49%,87.23%,98.91%.(4). there were6cases of residual/recurrent in all of the71patients, which the residual/recurrent rate was8.45%. The residual/recurrent rate for post-operation patients with persistent positive HPV was higher than persistent negative HPV(P=0.014). In addition, The residual/recurrent rate for post-operation patients with positive cytology was higher than negative cytology (P=0.017).(5). HPV for predicting residual/recurrent disease of post-operation CINⅡ-Ⅲ sensitivity, specificity, positive predictive value and negative predictive values were83.33%,38.10%,27.78%,88.89%; TCT were50%,76.19%,37.5%,84.21%; HPV parallel connected with TCT were100%,23.81%,27.27%,100%, HPV series connected with TCT were33.33%,90.48%,50%,82.61%.(6). The residual/recurrent rates had nothing to do with age, nation, times of pregnancy, CIN grade, and glandular involvemen(P>0.05). However, It was connected with the therapeutic methods(P=0.005).Conclusion:HPV infection was closely related to the occurrence, evolution and prognosis of high-grade cervical intraepithelial neoplasia. HPV testing combined with TCT had a huge significance in CIN II-III diagosis and residual/recurrent prediction.