Application of cytology and high risk-human pappilomavirus testing in cervical lesion

Objective To evaluate the significance of cytology and high risk-human pappilomavirus(HR-HPV) testing in screening cervical lesion.Methods A total of 1436 cases with abnormal cervical smear were examined for HR-HPV by hybrid capture Ⅱ,then 841 cases of them received colposcopy with biopsy.Results In the 1436 cases,the positive rate of HR-HPV of ASC was 28.6%(269/939),LSIL 74.0%(288/389) and HSIL 88.0%(95/105).Among 841 cases undergone colposcopy,the pathology diagnosis as NILM、CINⅠ/HPV、CINⅡ/Ⅲ were 236,540 and 65 cases,respectively.And the positive rates of HR-HPV of the above three groups were 9.7%(23/236),60%(324/540) and 96.9%(63/65),respectively.In the 841 cases,410 cases was HR-HPV positive,94.4%(387/410) of which were or severer than CINⅠ/HPV,including 83.7%(324/387) CINⅠ/HPV and 16.3%(63/387) CINⅡ/Ⅲ.In the 841 cases,431 cases were HR-HPV negative,50.6%(218/431) of which were or severer than CINⅠ/HPV,including 99.1%(216/218) CINⅠ/HPV and 0.09%(2/218) CINⅡ/Ⅲ.For the detection of cervical intraepithelial neoplasia(≥CINⅠ/HPV),the sensitivity of cytology,HR-HPV,cytology combined with HR-HPV were 0.498,0.987,0.726,respectively and the specificity were 0.640,0.903,0.890,respectively.Significant differences among the three methods were observed(P0.001).For the detection of high-grade cervical intraepithelial neoplasia(≥CINⅡ/Ⅲ),the sensitivity of cytology,HR-HPV,cytology combined with HR-HPV were 0.938,0.687,1.000,respectively and the specificity were 0.969,0.552,0.485,respectively.Significant difference among the three methods was found in specificity(P0.001),but not in sensitivity(P0.05).Conclusions Cytology and HR-HPV testing are the practical methods for detecting cervical lesion.Cytology combined with HR-HPV testing is the optimal screening approach of cervical lesion.