To Study The Application Value Of Artificial Intelligence Cervical Cancer Screening System(TruScreen) In High-risk HPV-positive Patients Lesions Screening

Object:Comparative analysis of the effectiveness of Tru Screen(TS)and TCT in the diagnosis of cervical cancer and precancerous lesions in high-risk HPV-positive patients,with a view to seeking a simpler and effective method for early screening of cervical cancer.Methods:Participants: 483 patients with high-risk HPV detection of cervical cancer in our gynaecological clinic from December 2016 to December 2018 were selected as subjects.Methods: All subjects were followed by TS,TCT,and colposcopy biopsy.The biopsy pathological examination was used as the "gold standard".The sensitivity,specificity,area under the ROC curve(AUC),negative predictive value,positive predictive value,and Kappa value of the consistency test statistic with biopsy pathological results were calculated and compared between TS and TCT for cervical cancer and precancerous lesions.The research content is divided into three aspects: 1.Comparative analysis of TS and TCT in the diagnosis of cervical cancer and precancerous lesions in high-risk HPV-positive patients(483 cases,including HPV16/18+ and HPV other+);2.Comparative analysis of TS and TCT in the diagnosis of cervical cancer and precancerous lesions in high-risk HPV other positive patients(338 cases);3.Evaluationof TS in the diagnosis of cervical cancer and precancerous lesions in patients with negative TCT results and high-risk HPV-positive patients(281 cases).Interpretation of the test results: biopsy pathological results ? LSIL as "abnormal";TS test output is "abnormal",representing cervical lesions ? LSIL,when the output is "normal",it means no intraepithelial neoplasia of the cervix;TCT examination Result? ASCUS is "abnormal".The operators of each examination are respectively implemented by different physicians,all operators are trained in formal operation,and other examination results of the patients are not known.The pathological reading was performed by the same experienced pathologist and the final pathological diagnosis was given,and the pathologist did not know the other findings of the patient.Results:1.Among 483 high-risk HPV-positive patients,the negative predictive value of TS and TCT for cervical cancer and precancerous lesions were 82.82% and 65.12%,respectively;the positive predictive values were 80.54% and 61.88%,respectively;the Kappa values of the consistency test statistic with the biopsy pathological results were0.633 and 0.266,respectively(p<0.0001);the sensitivity was 79.82% and 56.05%,respectively;the specificity was 83.46%.70.38%;the area under the ROC curve(AUC)was 0.816 and 0.632,respectively,and the difference in area under the ROC curve was statistically significant(p<0.0001).2.In 338 high-risk HPV other positive patients,the negative predictive value of TS and TCT for cervical cancer and precancerous lesions were 83.07% and 67.20%,respectively;the positive predictive values were 77.18% and 57.05%,respectively;the Kappa values of the consistency test statistic with the biopsy pathological results were0.603 and 0.243,respectively(p<0.0001);the sensitivities were 78.23% and 57.82%,respectively;the specificity was 82.20.%,66.49%;area under the ROC curve(AUC)were 0.802,0.622,respectively,and the difference in area under the ROC curve was statistically significant(p<0.0001).3.In 281 TCT results <ASCUS,high-risk HPV-positive patients,the negative predictive value,positive predictive value,the Kappa values of the consistency test statistic with the biopsy pathological results,sensitivity,specificity,the area under the ROC curve(AUC)of TS in diagnosis for cervical cancer and precancerous lesions were 82.06%,100%,0.6538(p<0.0001),59.18%,100%,and 0.796(p<0.001),respectively.Conclusions:This study shows that the sensitivity and specificity of TS screening for cervical cancer and precancerous lesions is higher than TCT in high-risk HPV-positive populations,and TS can be used as a method for cervical cancer screening.