Application of high-risk human papillomavirus detection and liquid-based cytology in cervical lesion screening

【Objective】 To assess the value of combining high-risk human papillomavirus(HPV) test and cytological test in cervical lesion screening.【Methods】 During August 2008 to April 2010,a total of 4144 women were screened by combining high-risk HPV DNA test(hybrid capture Ⅱ,HC-Ⅱ) and cytological test(liquid-based Thin Prep cytology test),and the 880 abnormal cervical smear cases were further biopsied under the colposcope.【Results】 In the 4144 cases,the positive rate of cytology and HR-HPV test were 21.24%,32.41%.Among the 880 abnormal cervical smear cases,the positive rate of HR-HPV of ASC 34.47%(202/586),LSIL69.32%(113/163),HSIL89.08%(106/119),SCC100%.In 880 cases under gonecolposcopy,the pathology diagnosis as cervicitis,CINI,CINII,CINIII,SCC were 237,382,96,111,54,and the positive rates of HR-HPV of the above five groups were 15.19%(36/237),41.88%(160/382),80.21%(77/96),97.30%(108/111) and 98.15%;The rate of pathology diagnosis more than CINI was 73.07% in 880 abnormal cervical smear cases and 91.69% in 421 positive HR-HPV cases.For the detection of cervical intraepithelial neoplasia(≥CINI),the sensitivity of cytology,HR-HPV,cytology combined with HR-HPV were 45.26%,61.90%,77.14%,respectively and the specificity of cytology,HR-HPV,cytology combined with HR-HPV were 98.73%,85.23%,77.14%,respectively.Significant differences among the three methods were observed(P 0.05).The negative-predictive value of cytology,HR-HPV,cytology combined with HR-HPV were 39.93%,44.01%,44.37%,there was no significant differences observed(P 0.05).For the detection of high-grade cervical intraepithelial neoplasia(≥CINI),the sensitivity of cytology,HR-HPV,cytology combined with HR-HPV were 81.23%,93.10%,97.70%,respectively.Significant differences among the three methods were observed(P 0.05).The specificity of cytology,HR-HPV,cytology combined with HR-HPV were 76.27%,68.50%,64.80%,respectively and the negative-predictive value of cytology,HR-HPV,cytology combined with HR-HPV were 91.13%,92.35%,99.15% respectively,there was no significant differences observed(P 0.05).【Conclusions】 High-risk HPV DNA test has high sensitivity and negative-predictive value.The combination of high-risk HPV DNA test and cytological test increases the sensitivity and negative-predictive value,it was the key of cervical cancer screening.The performance of biopsy under the colposcope can help the diagnosis of cervical dysplasial.