Evaluation Of Clinical Application Of Cervical Disease Screening Program

Objective:To compare three types of screening through the collection and analysis of clinical data:neo-Paklet’s liquid-based cytology（TCT）,high-risk human papilloma virus type 16/18（HR-HPV16/18）,and a combination of the two Methods:To investigate its clinical diagnostic value in screening for cervical lesions;to observe the relationship between P16,Ki67 protein and HR-HPV16/18 infection and different degrees of cervical lesions in different cervical intraepithelial neoplasias（CIN）,and to explore its clinical significance Application value:Based on the results of the five combined measurements of Epitav,to explore whether the vaginal microecology is related to the occurrence and development of cervical lesions.The aim is to provide reference for early screening and prevention of cervical lesions.Methods:Collected from January 2018 to June 2019 in the Gynecology Clinic of the First Affiliated Hospital of Shihezi University School of Medicine,and performed five combined tests of TCT,HR-HPV,and Aibiwei（five combined tests of bacterial vaginosis box）and patients with cervical histopathology as research objects,after analyzing the data,explore the clinical diagnostic value of each detection scheme in screening cervical lesions.Results:1.The positive rate of HR-HPV16/18 group above HSIL（64.23%）was significantly higher than that of group below LSIL（34.95%）,and the difference was statistically significant（P<0.05）;The positive rates detected by TCT in the LSIL group,HSIL group,and cervical cancer group were:71.28%（67/94）,83.61%（102/122）,86.67%（13/15）;Any pairwise comparison of the positive rates between groups,except for the difference in positive rates in the HSIL group and cervical cancer group（χ²=1.058,P=0.522>0.05）,the other groups have differences in comparison.Statistical significance（P<0.05）.The positive rates of HR-HPV16/18 in LSIL group,HSIL group and cervical cancer group were:44.68%（42/94）,59.84%（73/122）,100%（15/15）;3 groups The positive rate of the two groups was statistically significant（P<0.05）.As the degree of cervical lesions increased,the positive rate also increased.The coincidence rate of cervical lesions detected by TCT was 78.79%（182/231）,and the coincidence rate of cervical lesions detected by HR-HPV16/18 was 56.28%（130/231）.Statistical significance（χ²=5.75,P=0.021<0.05）.The coincidence rate of the combined detection of cervical lesions was 95.24%（220/231）;there was a statistically significant difference in coincidence rates when compared with the separate tests of TCT and HR-HPV16/18（both P<0.05）.The HR-HPV16/18 test has the highest sensitivity and negative predictive value;the specificity and positive predictive value of the combined detection are the highest.2.Women with hydrogen peroxide（H₂O₂）,sialidase（SNA）,leukocyte esterase positive（LE）,low number of lactobacilli,and vaginal cleanliness of 3-4 degrees are infected with HR-HPV16/18 and the possibility of cervical disease The sex was significantly greater than that of the women with negative indicators mentioned above,with a large number of lactobacilli,and vaginal cleanliness of 1-2 degrees,and the differences were all statistically significant（P<0.05）.After multivariate Logistic regression analysis,it was found that H₂O₂,SNA,LE,and vaginal cleanliness were 3-4 degrees of risk factors for cervical lesions（P<0.05）.3.The positive rates of P16 and Ki-67 in HR-HPV16/18 and ordinary HR-HPV were significantly different between the two groups（P<0.05）.The detection rate of P16 was 87.45%（202/231）,and the detection rate of Ki-67 was 91.78%（212/231）.The detection rates of the two were similar,and the difference was not statistically significant（P=0.13>0.05）;the detection rate of cervical lesions in the combined detection of 97.40%（225/231）;the detection rates were statistically significant compared to P16 and Ki-67 alone（χ²=16.35,7.15,borh P<0.05）.The differences of P16,Ki-67 and their combination in LSIL-and HSIL+groups were statistically significant（P<0.05）.Spearman rank correlation analysis results showed that:P16 and Ki-67 expression were significantly positively correlated（r=0.477,P<0.05）;P16,Ki-67 expressions and cervical lesions were significantly positively correlated（r=0.754,0.530,both P<0.05）.Conclusion:1.TCT,HR-HPV16/18 combined detection is better than single detection.2.The vaginal microecological imbalance is related to HR-HPV16/18 infection and cervical lesions,which can provide new ideas for screening cervical lesions.3.The expressions of P16 and Ki67 are positively correlated with HR-HPV16/18 and cervical lesions.Combined screening,especially high-grade cervical lesions,has a high accuracy rate.