| Objective:According to the cervical pathological diagnosis of the patient,the predictive value of HPV and cytology for the diagnosis of cervical lesions was analyzed by comparing the results of the cervical disease examination,HPV infection and cytology of the patientMethods:Using the method of retrospective analysis,select patients with cervical examinations in the gynecology clinic or inpatient department of the Second Affiliated Hospital of Kunming Medical University from January 2015 to October 2019.According to the results of the examination,they are divided into:cervical cancer-related lesions 1004 2184 cases of non-cervical cancer-related lesions were compared with the corresponding HPV and cytological examination results in different cervical lesions,and the predictive effects of two cervical cancer screening methods on cervical lesions were analyzed.Use SPSS23.0 software for data processing and statistical analysis.Results:1.Age:in this group of data,3188 patients with cervical pathological diagnosis,the maximum age is 82 years old,the minimum age is 15 years old.According to the age interval,they are divided into 5 groups:15-25 years old,26-35 years old,36-45 years old.46-55 years old,56-65 years old,66 years old.In each group,the pathological diagnosis results are divided into other cervical lesions not related to cervical cancer,Cini,cini-iii,cinii/in situ cancer,CIN disease The incidence rate of incidence rate incidence of non cervical cancer related diseases,CIN lesions and invasive cancer in all age groups was compared.It was found that in the other cervical cancer patients with non cervical cancer,the incidence rate of 15?25 years old was the lowest,and the incidence of patients aged 26?65 years was not significantly different(P<0.05);in CIN disease,the highest incidence rate was in patients with 26?35 years old.The incidence rate of incidence rate incidence rate was higher than that of patients aged 36 years or above(P>0.05),but the incidence rate was not significantly different from those of 15?25 years old(P<0.05).The incidence of 46?55 was the highest among invasive cancer patients,followed by those aged 36?45 years.There was no significant difference in incidence between the two groups(P>0.05),but the incidence of these two age groups was higher than that of any other age group(P<0.05).2.Non cervical cancer related lesions:2184 of 3188 cases were not related to cervical cancer,including 1908 cases of cervicitis,260 cases of cervical polyps,7 cases of squamous papilloma and 9 cases of no lesions.There were 846 cases,45 cases,6 cases and 2 cases of HPV in each lesion,and 679 cases,7 cases,6 cases and 2 cases of HPV were positive,with a positive rate of 80.3 respectively%?15.6%?100%?100%?It can be seen that there is also a high positive rate of HPV in other lesions not related to cervical cancer.3.Cervical cancer-related lesionsAmong the 3188 cases of cervical disease examination,there were 1004 patients with cervical precancerous lesions or cervical canceration,including 616 HPV-positive patients,including 409 cases with positive HPV typing(PCR)test and(HC2)positive test 207 cases.35 cases of HPV negative patients.There were 417 cases with cytology.3.1.In 409 cases with positive HPV typing,384 Cases of high-risk HPV infection,11 cases of low-risk HPV infection,14 cases of mixed HPV infection.The number of patients with cervical lesions of Cini,cinii and above under these three kinds of HPV infection conditions were counted respectively,and the differences among the three kinds of HPV infection in Cini,cinii and above cervical lesions were compared.It was found that the patients with low-risk HPV infection in Cini lesions were far away The difference was significant(P<0.05)between the patients with high-risk HPV infection and those with low-risk HPV infection(P<0.05)in cervical lesions of cinii and above,and the difference was significant(P<0.05);however,the infection of low-risk HPV and mixed HPV,high-risk HPV and mixed HPV in cervical lesions of different levels were not clear Significant difference(P>0.05).3.2.384 of 409 PCR positive patients were high-risk infection.They were divided into 16/18 high-risk group,16/18 combined with other high-risk groups,and non-16/18 high-risk groups according to the type of HPV infection.The patients in each group were divided into Cini group,cinii group,cini-iii group,cinii/in situ cancer group and invasive cancer group according to the results of cervical disease test.The infection of different HPV types was compared Results there was no significant difference in cervical lesions between 16/18 high-risk group and 16/18 combined with other high-risk groups,and between 16/18 combined with other high-risk groups and non-16/18 high-risk groups(P>0.05),but there was significant difference between non-16/18 high-risk group and 16/18 high-risk group(P<0.05)The incidence of Cini in high-risk group was lower than that in non-16/18 high-risk group,while the incidence of cinii-iii,cinii/carcinoma in situ and invasive cancer was significantly higher than that in non-16/18 high-risk group.3.3.207 patients with positive HPV detected by HC2 were divided into Cini group,cinii group,cinii-iii group,cinii/in situ cancer group and invasive cancer group by cervical pathological diagnosis.The results showed that there was no significant correlation between the severity of cervical lesions and the amount of viral load(P>0.05).3.4.Among 207 high-risk HPV positive patients detected by HC2,119 had cytological examination results at the same time.It was divided into two groups:normal cytology group(nilm)and abnormal cytology group(?ASCUS).The viral load of the two groups was compared,and it was found that there was a correlation between the normal cytological results and the viral load(r=0.252,P=0.006<0.05).It was found that the viral load of abnormal cytology group was significantly higher than that of normal cytology group(P<0.05).The patients with abnormal cytological results were further divided into ascus/ASC-H,LSIL and HSIL groups.The viral load of each group was compared in two pairs,and there was no significant difference(P<0.05);see Table 7 for the results.In the cytological examination results of ASCUS/ASC-H,LSIL and HSIL,the viral load of each group was divided into low load group(1.00-99.99),medium load group(100.00-999.99)and high load group(?1000.00);in ascus/ASC-H group,the viral load of low,medium and high time accounted for 30%,60%and 10%respectively;in LSIL group,the viral load was negative In the HSIL group,the viral load was 22.2%,33.3%and 44.4%in the low,medium and high-dose group,respectively;in the cytological examination results of the three groups,the viral load was 17.9%,50%and 32.1%in the low,medium and high-dose group,and there was no significant difference(P>0.05).3.5.There were 417 patients with cytological examination,of which 174 had abnormal cytological examination(?ASCUS),the total abnormal rate was 41.7%(174/417).The abnormal rates of cytology were 19.65%(34/173),35.0%(28/80),53.13%(34/64),72.13%(44/61)and 87.18%(34/39)in CIN ? group,CIN ?group,CIN ?-? group,CIN ?/in situ cancer group and invasive cancer group,respectively.It can be seen that the abnormal rates of cytology were more significant when the cervical lesions were of high grade(P<0.05).3.6.35 cases of HPV negative cervical lesions were mostly treated for clinical symptoms.Finally,cervical examination was carried out.27 cases of Cini,5 cases of cinii,1 case of cinii/carcinoma in situ and 2 cases of invasive cancer(1 case of squamous cell carcinoma and 1 case of adenocarcinoma)were found.It can be seen that when HPV test is negative,cervical precancerous lesions or cervical cancer may also occur.Conclusion:1.incidence rate of incidence rate of non cervical cancer related diseases may be low in 15?25 years old patients.In CIN disease,the incidence rate of 26?35 is the highest.In invasive cancer,the highest incidence is in 46?55 years old patients,followed by 36?45 years old patients.The majority of patients with canceration are middle-aged and elderly women over 35 years old.It may be because it takes several years or even more than ten years to develop from HPV infection to malignant tumor.2.There are a lot of non cervical cancer related lesions related to HPV infection in clinic,and proper follow-up observation is also needed for these patients to avoid long-term persistent HPV infection in some of them and further develop into cervical precancerous lesions or cervical cancer.3.The high-level cervical lesions above cinii are mostly caused by the continuous infection of HR-HPV,and the main pathogenic subtypes are 16 and 18.However,the mixed infection of 16 and 18 HPV and other high-risk HPV does not increase the chance of cervical lesions to develop to high-level.Therefore,in the clinical cervical cancer screening work,while strengthening the follow-up observation of type 16 and type 18 positive patients,it is not necessary to over screen and diagnose and treat the patients mixed with type 16,type 18 and other high-risk HPV infection at the same time,so as to avoid increasing the psychological and cost burden of patients.4.In this data,there is no significant correlation between the severity of cervical lesions and the load of HPV.5.In the data of this group,there is a connection between the results of cytology and the viral load.The viral load of patients with abnormal cytology is significantly higher than that of patients with normal cytology,but the abnormal degree of cytology is not significantly related to the viral load of HPV.6.The more serious the cervical lesions,the higher the abnormal detection rate of cytology.7.Patients with cervical precancerous lesions or cervical cancer who are negative for HPV in clinic are often found by clinical symptoms.Therefore,we should also pay attention to HPV negative screeners in cervical cancer screening work.We should pay attention to the screening combined with the clinical symptoms of the screeners and other factors.If necessary,these HPV negative screeners still need to carry out colposcopy or cervical biopsy to reduce leakage The rate of diagnosis decreased the incidence rate of cervical cancer in women. |
PDF Full Text Request