| Objective:To analyze and compare the application value of FH test,cervical exfoliated cells special staining technique,liquid-based cytology(TCT)and HPV DNA test in cervical cancer screening,so as to provide reference for improving the screening effect of female cervical cancer.Method:Part I: A prospective trial was conducted to select a total of 550 women who underwent cervical cancer screening in our hospital from November,2017 to August,2018.Meanwhile,FRD,TCT or HPV tests were performed.Colposcopy was performed on any of the subjects with abnormal conditions,tissue samples were collected at the same time,and biopsy was performed.The pathological results were taken as the gold standard,and the application value of several detection methods in cervical cancer screening was compared.Part Ⅱ: On the basis of 2 hospitals cross-sectional,blind method,select into standard female population,given the FH detection and TCT detection,to any item which indicates a abnormal situation of the research object colposcope examination,tissue samples collected at the same time,the line of living tissue pathology examination,a total of 103 people,with pathologic results as the gold standard,compare the FH detection with TCT testing method of detection.PartⅢ:During 2017.11 2018.08 in our hospital were randomly selected 550 cervical cancer screening women who,all patients were performed cervical exfoliated cells special dyeing technology inspection(FRD)and liquid based cytology(TCT)and human papilloma virus(HPV),the use of cost-effectiveness analysis,compare the TCT screening strategy,FRD joint TCT diagnostic screening strategy,joint TCT FRD series parallel screening strategy,HPV joint TCT series diagnostic screening strategy four screening methods,contrast the economic value of various kinds of detection methods.Result:Part I: With the pathological diagnosis of HSIL above lesions is positive standard,cervical exfoliated cells when special staining positive for pathological diagnosis,the sensitivity was 89.29%,specificity of 59.55%,the sensitivity of TCT examination was 83.92%,specificity of 62.92%,the sensitivity of the HPV examination was 87.50%,specificity of 43.82%,the sensitivity of three detection methods have certain differences,P < 0.05,the difference was statistically significant.The specificity of the three detection methods was P>0.05,and the difference was not statistically significant.Part II: The sensitivity and specificity of cervical FH test for cervical cancer screening were 89.47% and 60.87%,respectively,which were similar to the sensitivity of TCT test(P > 0.05),but its specificity was lower than that of TCT test(P < 0.05).Part III : TCT screening strategies:(1)use TCT screening,there’re a total of 28 cases were positive,550 cases of patients with positive in cervical tissue multi-point biopsy under colposcope,according to its pathological examination result,CIN Ⅱ and above positive patients in 4 cases,14.29%(4/28).The cost of each positive patient was RMB 51894.(2)Parallel diagnosis and screening strategy of FRD combined with TCT: among 550 cases,42 patients were found to be TCT positive or FRD positive,or both were suspected positive or above,among which 5 cases were pathologically positive,accounting for 11.90%(5/42).The cost of each positive patient was RMB 52372.8.(3)FRD combined with TCT series diagnostic screening strategy: a total of 33 patients with positive or suspected positive FRD screening were performed,and further TCT screening was planned,among which a total of 18 patients were positive,requiring multi-point biopsy of cervical tissue under colposcope.There were 5 cases with positive pathological diagnosis,accounting for 27.78%(5/18).The cost of each positive patient was RMB 13507.2.(4)HPV combined with TCT series diagnostic screening strategy: a total of 117 patients with positive HPV screening were performed,further TCT examination was performed,and a total of 21 patients with positive TCT were performed.Therefore,multiple point biopsy of cervical tissue under colposcopy was required.There were 6 cases with positive pathological diagnosis,accounting for 28.57%(6/21).The cost of each positive patient was RMB 35717.0.Conclusion:(1)Compared with TCT,the special staining technique for cervical abscisated cells has a higher sensitivity,and has a good application effect in the screening of high-grade cervical lesions,with no obvious adverse reactions to normal tissues.It has a high practicality in screening and can well solve the problem of the shortage of pathologists.Cervical cancer screening is a new,rapid,economical screening method,suitable for clinical application.(2)FH detection technology has good diagnostic value in the judgment of high-grade cervical lesions.Due to the advantages of simple operation,non-invasive,high accuracy and short detection cycle,it is also suitable for the screening of large sample size or remote areas.(3)The special staining technique of exfoliated cells in cervical tissue can be used for screening,and its combined TCT series diagnostic and screening strategy has obvious economic and health advantages. |
