Research On The Correlation Between HPV Infection And Cervical Lesions And Its Genotype In Combination With TCT In Cervical Disease Screening

Objective:Analyze human papilloma virus(HPV)genotype distribution ages and multiple infection mode of cervical lesions in Hefei.Discuss the different cervical cancer screening method in the application value of screening for cervical cancer and precancerous lesions.Methods:Retrospectively,we reviewed and analyzed the clinical data of 2535 patients,who visited the department of Obstetrics and Gynecology clinic and received cervical cancer screening.Cervical cancer screening method include cervical cytology test and HPV test.Cervical cytological specimen was detected by liquid-based thinlayer cytology test(TCT)and HPV was genotyped by PCR reverse dot blot.Based on the pathologic analysis of cervical biopsy,230 patients were received cervical biopsies divided into benign lesions/low grade squamous intraepithelial lesions(LSIL)and high-grade squamous intraepithelial lesion(HSIL)/squamous cell carcinoma(SCC)groups.Statistical analysis was operated on HPV infection patterns and types.It shows that 203 cases were offered the TCT and the typing test for HPV and also the referral colposcope parallel cervical biopsy.Based on the pathologic analysis of cervical biopsy,the diagnostic value of the TCT,the typing test for HPV and the packaging screening both of them in the application of screening cervical carcinoma.Results:The total number of positive cases in 2535 samples was 734,accounting for29%.HPV multiple infected patients are accounted for 70.9%(514/734)among the total of HPV infected ones.Single infected patients is accounted for 29.1%(220/734)among the total of HPV infected ones.HPV16?HPV52?HPV58?HPV53 and HPV33 were the five most popular genotypes with detection rates of 7.1%?5.2%?3.9%?1.7%and 1.6%,respectively.Via the comparison between HPV infection cases in different age groups,it is founded that age group between 21-30 years old infection rate was 30.1%(151/501),age group between 61-70 years old infection rate was 47.9%(47/98).The infection rate of HPV was 50.4%in cervical Benign lesions/low-grade squamous intraepithelial lesion(LSIL)and 87.6%in cervical high-grade squamous intraepithelial lesion(HSIL)/squamous cell carcinoma(SCC).The HPV infection rates between the two groups had a significant difference(?~2=33.247,P=0.000).The single infected rate of HPV was 29.1%(41/141)in cervical Benign lesions/low-grade squamous intraepithelial lesion(LSIL)and 65.2%(58/89)in cervical high-grade squamous intraepithelial lesion(HSIL)/squamous cell carcinoma(SCC).The HPV infection rates between the two groups had a significant difference(?~2=28.988,P=0.000).The multiple infected rates of HPV was 21.3%(30/141)in cervical Benign lesions/low-grade squamous intraepithelial lesion(LSIL)and22.4%(20/89)in cervical high-grade squamous intraepithelial lesion(HSIL)/squamous cell carcinoma(SCC).The HPV infection rates between the two groups had no significant differencehere(?~2=0.046,P=0.831).The highest detection rates of cervical lesions above LSIL were HPV16,HPV58,HPV52,HPV33 and HPV18,all of which were high-risk.The proportion of HPV16(37.5%)in cervical HSIL+lesions was higher than that of HPV58(11.6%)and HPV52(8.9%).The differences between the two groups were statistically significant(?~2=3.257?6.917,P<0.05).Three screening methods were compared,the specificity,accuracy,positive predictive value and positive likelihood ratio of TCT were the largest.The sensitivity and negative predictive value of TCT+HPV combined screening were the largest.The area under the curve(AUC)of three screening methods from high to low arrangement is TCT single screening>TCT+HPV combined screening>HPV single screening.Conclusion:The HPV16?HPV52?HPV58?HPV53 and HPV33 are the dominant infection genotypes among women in Hefei,HPV infection rate was 29.0%.It is founded that age groups between 21~30 years old and 61~70 years old have a higher probability of being infected.HPV16?HPV58?HPV52 were the three most popular genotypes in people with cervical lesions,the infection rate of HPV is ascending with a serious degree of the cervical lesion.Three screening methods were compare,the TCT single screening testing accuracy is best,so it has the highest probability of finding true positives.The sensitivity of HPV combination of TCT is highest.