Correlation Between HR-HPV And Abnormal Dna Ploidy And Application Of DNA Ploidy Analysis In Cervical Cancer Screening

Objectives: To study the correlation between high-risk human papillomavirus(HR-HPV)infection and abnormal DNA ploidy in cervical cells,and to explore the clinical value of DNA ploidy analysis in cervical cancer screening.Methods and objects: 527 cervical samples with HPV typing detection were selected in Wu clinic from March 2016 to December 2016.Pap staining was used for The Bethedsa System diagnose of cytological examination,Feulgen method for automatic DNA ploidy quantitative analysis.The uncertain cases were required to be deteced cervical biopsy via electric colposcopy in order to analyze the value of DNA ploidy analysis in cervical cancer screening.Results:(1)The HR-HPV infection rate was different between different DNA ploidy.With the increase of the abnormal degree of DNA ploidy,the infection rate of HR-HPV was 9.56%,50%,72.73%,and 88.46%,increased correspondingly,the difference was statistically significant.Among the patients with single or multiple HR-HPV infection,the positive rate of DNA ploidy analysis was 38.55% and 31.82%,and the difference was not statistically significant.The positive rates of DNA ploidy analysis of HPV16,HPV52 and HPV58 infection were 45.83%,25% and 66.67%,and the difference was not statistically significant.(2)The sensitivity,specificity,positive predictive value and negative predictive value of HR-HPV detection were 91.67%?29.51%?43.42% and 85.71%;The sensitivity,specificity,positive predictive value and negative predictive value of TCT were 77.78%?49.18%?47.46% and 78.95%;The sensitivity,specificity,positive predictive value and negative predictive value of DNA ploidy analysis were 86.11%?72.13%?64.58% and 89.80%,when the pathology result is at CINII or above.(3)DNA ploidy analysis as a shunting method for HR-HPV detection: the sensitivity,specificity and Youden's index were 91.67%?40.98% and 32.65%;TCT as a shunting method for HR-HPV detection: the sensitivity,specificity and Youden's index were 80.56%?44.26% and 24.82%;DNA ploidy analysis combined with TCT as a shunting method for HR-HPV detection:the sensitivity,specificity and Youden's index were 91.67%?34.43% and 26.10%,when the pathology result is at CINII or above.Conclusion:(1)HR-HPV infection is an important factor causing abnormal DNA ploidy in cervical cells;There was no correlation between the abnormal degree of DNA ploidy and the number of HR-HPV subtypes,the multiple HR-HPV infection does not increase the risk of abnormal cervicalcell DNA ploidy.(2)The sensitivity and specificity of DNA ploidy analysis arehigh,and its Youden's index is higher compared with HR-HPV detection and TCT.It can be used as an effective screening method for cervical cancer and improve the accuracy and efficiency of screening.HR-HPV screening for primary screening combined with DNA ploidy analysis shunt screening efficacy is the highest among the three cervical cancer screening programs which HR-HPV detection as a primary screening.