Clinical Application Value Of Detection Of Human Papillomavirus L1 Capsid Protein ?Cervical Cytology?HPV Testing In Diagnosis Of Cervical Lesion

BcakgroudCervical cancer is a common source of gynecological diseases in cervical squamo columnar junction of the malignant tumor,a serious threat to women's quality of life.The global annual new cases of cervical cancer patients about 529 thousand people,of which 85% were in developing countries.Persistent infection of human papilloma virus(HPV)is closely related to the development of cervical cancer,,HPV has 100 subtypes,can be divided into high-risk HPV(HR-HPV)and low risk HPV(LR-HPV).At present,China has introduced a series of methods in the prevention and treatment of cervical cancer,such asHPV typing?HPV L1 protein detection ? HPV vaccine and TCT detection ?In recent years,many scholars are trying to find more valuable methods,it is better to guide the clinical diagnosis and treatment of cervical lesions.ObjectiveTo investigate the clinical application value of detection of human papillomavirus L1 capsid protein?thinprep cytoligic test(TCT)? HPV typing in diagnosis and treatment of cervical lesion.MethodForm July 2014 to June 2015,A total of 1203 patients who were diagnosed as cervical abnormalities during physical examination in outpatient department of gynecology was enrolled as eligible women form the Frist Affiliated Hospital of Xinxiang Medical University,they all received TCT and HPV genotyping detection,These women,such as TCT positive ? high-risk HPV(HR-HPV)positive and both positive,all underwent colposcopy and biopsie.The expressions of HPV L1 caspid protein in abnormal TCT results were detected by immunocytochemistry.ResultIn one hundred and fifty-six patients with abnormal TCT results,high risk HPV positive rate of no definitive diagnosis significance of atypical squamous cells(ASCUS),low-grade squamous epithelial cell lesions(LSIL),the height of squamous intraepithehal lesion(HSIL),squamous cell carcinoma(SCC)was respectively 19.1%(13/68)?35.3%(18/51)?77.8%(21/27)?100%(10/10).The positive rate of HR-HPV in TCT results for high grade cervical intraepithelial neoplasia was higher,and LR-HPV was mainly found in low grade cervical intraepithelial neoplasia.The positive rate of cervical intraepithelial neoplasia(CIN)and more gradually of no definitive diagnosis significance of atypical squamous cells(ASCUS),low—grade squamous epithelial cell lesions(LSIL),the height of squamous intraepithehal lesion(HSIL),squamous cell carcinoma(SCC)was 54.4%(37/68),60.8%(31/51),85.2%(23/27),10/10.TCT results for low grade cervical lesions accord with histopathological results is lower than high grade cervical lesions(?~2 =49.762,P<0.001).With the increased of TCT detection,the results of TCT were consistent with histopathological.In 262 cases of histological abnormalities,the accuracy rate of TCT combined with HPV typing test for diagnosis of cervical lesions was significantly higher than that of the single positive(?~2 =50.095,P<0.001;?~2 =72.034,P<0.001).TCT combined with HPV-DNA typing detection in CIN III and above cases of double positive detection rate was the highest,and SCC reached 100%.The expression rate of HPV L1 capsid protein in low grade cervical lesions was significantly higher than that in high-grade cervical lesions(?~2 =22.75,P<0.001).HPV L1 capsid protein was gradually decreased with histopathological diagnosis level.156 cases were divided into two groups by 35 years of age,the positive expression rate of HPV L1 capsid protein in the group younger than 35 years is more than the group older than 35 years(?~2 =18.203,P<0.001).ConclusionThe positive rate of HR-HPV in TCT results for high grade cervical intraepithelial neoplasia was higher,and LR-HPV was mainly found in low grade cervical lesions.The accuracy rate of TCT combined with HPV typing test for diagnosis of cervical lesions was higher than that of the single positive,they can be used as a clinical screening method of cervical lesions.The positive rate of HPV L1 caspid protein was decreased with the severity of cervical lesions and age,which can be a helpful molecular biomarker in risk assessment and prognostic prediction.It has a certain guiding significance for the clinical screening of cervical lesions.