Screening values of cervical DNA ploidy analysis combined with cervical cytology test for cervical cancer

Objective To explore the screening values of cervical DNA ploidy analysis combined with cervical cytology test for cervical cancer. Methods A total of 862 women who underwent cervical cancer screening in West China Second University Hospital, Sichuan University from January 1 to October 31, 2016 were selected as research subjects by retrospective study method. All participants received cervical DNA ploidy analysis and cervical ThinPrep liquid-based cytology test (TCT). Those who were positive for cervical DNA ploidy analysis or TCT were examined by colposcopy, and cervical tissues were taken for pathological examination. Cervical biopsy results were taken as the gold standard . The sensitivities, specificities, positive predictive values and negative predictive values of three screening methods including cervical DNA ploidy analysis, TCT, and the combination of these two methods for screening cervical intraepithelial neoplasia (CIN) grade 2 or worse (CIN2+ ). The screening values of these three screening methods for CIN2+ were compared. The procedures in this study were in line with the requests of the World Medical Association Declaration of Helsinki revised in 2013. Results ①The histopathological diagnosis results of those 862 subjects in this study were as follows. There were 655 cases (76.0%) of normal cervical tissue, 109 cases (12.7%) of CIN1, 45 cases (5.2%) of CIN2, 39 cases (4.5%) of CIN3, 14 cases (1.6%) of cervical cancer, and the detection rate of CIN2+ was 11.4% (98/862). The results of cervical DNA ploidy analysis showed that there were 280 cases (32.5%) of subjects with positive results, among whom 94 cases were CIN2+ , and the detection rate of CIN2+ was 10.9% (94/862). The results of TCT showed that 272 cases (31.6%) with positive results of TCT were detected, among whom 93 cases were CIN2+ , and detection rate of CIN2+ was 10.8% (93/862). The cervical DNA ploidy analysis combined with TCT screening results showed that 308 cases (35.7%) were with positive results, among whom 95 cases were CIN2+ , and the detection rate of CIN2+ was 11.0% (95/862). ② Sensitivities of cervical DNA ploidy analysis, TCT and the combination of those two methods for the screening of CIN2+ were 95.9% (94/98), 94.9% (93/98) and 96.9% (95/98), respectively, and specificities were 75.7% (578/764), 76.6% (585/764) and 72.1% (551/764), respectively, and positive predictive values were 33.6% (94/280), 34.2% (93/272) and 30.8% (95/308), respectively. Negative predictive values were 99.3% (578/582), 99.2% (585/590) and 99.5% (551/554), respectively. Sensitivity and negative predictive value of the combination of cervical DNA ploidy analysis and TCT for the screening of CIN2+ both were higher than those of the two methods alone. Conclusions Screening values of cervical DNA ploidy analysis combined with TCT for cervical precancerous lesions and cervical cancer are superior to those two methods alone, and the combination screening method can improve the screening accuracy rate for cervical lesions. Because this study is just a retrospective study, the screening values of the combination of these two methods in screening for cervical precancerous lesions and cervical cancer remains to be confirmed by large-sample, multicenter, prospective randomized controlled trials. Key words: Cervical neoplasms; Cervical intraepithelial neoplasia; DNA ploidy analysis; Cervical cytology test; Combined screening; Female