The Clinical Significance Of Free Body Of Iron Protoporphyrin Reduced State On The Diagnosis Of Cervical Precancerous Lesion

Objective: To explore the clinical significance of free body of iron protoporphyrin reduced state on the diagnosis of cervical precancerous lesion.Methods: 336 women who received cervical cancer screening were selected from October 2014 to October 2016 in the department of obstetrics and gynecology of logistic university in Chinese people's armed police forces' s affiliated hospital.Totally explained the purpose of the test and signed the consent form.336 participants were divided into three groups:normal control group(297 participants diagnosed no precancerous lesion and cancer),Cervical precancerous lesion group(34 subjects who were diagnosed developing to cervical intraepithelial neoplasia,which including LSIL,HSIL)and the cervical cancer group(5 subjects diagnosed as cervical cancer).All of the participants underwent FH test,thinprep cytologie test(TCT),high-risk HPV detection,biopsies under colposcopy,as well as cervical pathological examination.The sensitivity,specificity,and ROC Curve were used to evaluate the clinical significance of FH.Results:1 For the study,pathological results were defined as the gold strandard.1.1 As for FH method,Se,FPR,Sp,FNR,Accurracy,Kappa,LR(+),LR(-),Youden index were 81.6%,18.4%,80.5%,19.5%,80.7%,0.40,4.18,0.23,0.62,respectively.1.2 As for TCT method,Se,FPR,Sp,FNR,Accurracy,Kappa,LR(+),LR(-),Youden index were 89.7%,10.3%,89.0%,11.0%,89.0%,0.59,8.15,0.12,0.79,respectively.1.3 As for HPV method,Se,FPR,Sp,FNR,Accurracy,Kappa,LR(+),LR(-),Youden index were 92.3%,7.7%,89.9%,10.1%,90.2%,0.63,9.14,0.086,0.822,respectively.1.4 ROC curve was used to evaluate the clinical significance.AUC for FH,TCT,and HPV were 0.813,0.893,0.936,respectively.HPV had better performance than FH.No statistical significance was found between TCT and FH.2.1 As for FH+TCT joint methods,Se,FPR,Sp,FNR,Accurracy,Kappa,LR(+),LR(-),Youden index were 87.2%,12.8%,71.7%,28.3%,73.5%,0.31,3.08,0.179,0.589,respectively.2.2 As for FH+HPV joint methods,Se,FPR,Sp,FNR,Accurracy,Kappa,LR(+),LR(-),Youden index were 94.9%,85.5%,14.5%,86.6%,0.55,6.54,0.059,0.804,respectively.2.3 As for TCT+HPV joint methods,Se,FPR,Sp,FNR,Accurracy,Kappa,LR(+),LR(-),Youden index is 97.4%,2.60%,92.3%,7.70%,92.7%,0.72,12.649,0.028,0.897,respectively.2.4 ROC curve was used to evaluate the clinical significance.AUC for FH+TCT,FH+HPV,and TCT+HPV combined methods were 0.794,0.902,0.948,respectively.TCT+HPV combined together showed better results than FH+TCT and FH+HPV cocmbined methods.No statistical significance was found between FH+TCT combined methods and FH+HPVcombined methods.Conclusions:1 The effect of FH detection on screening cervical precancerous lesions and the cervical cancer is similar to TCT test,but is lower than high risk HPV test,which offers a poor substitute for clinical diagnosis.2 The effects of FH combined with TCT test on screening cervical precancerous lesions and the cervical cancer is similar to FH test combined with HPV test,but is lower than TCT test combined with HPV test.FH can be employed as a supplementary means to identify distinctiveness3 Take consideration of FH test's simple operation,moderate price and safety,it can be served as a method for accessory examination of diagnosing cervical cancer,especially in less developed areas.