1.Evaluation of variable methods for HPV testing
Jiaoying CHENG ; Meilu BIAN ; Li MA ; Xiao CONG ; Ying CHEN ; Jun LIU
Chinese Journal of Obstetrics and Gynecology 2013;48(8):589-594
Objective To evaluate clinical efficacy of different HPV methods in screening of cervical cancers.Methods Between August 2011 and November 2011,424 women in the China-Japan Friendship Hospital were enrolled in this study.All participants were undergone liquid-based cytology test (LCT),Hybrid capture Ⅱ (HC-Ⅱ) and real-time (RT)PCR high risk HPV DNA test for HPV16 and HPV18 genotyping.Those results were classified into two group:424 women at HC-Ⅱ group with LCT and HC-Ⅱ test and 421 women at PCR group with LCT and PCR test.All women with atypical squamous cell of undetermined significance (ASCUS) or above in cytological result with high risk HPV positive at two group underwent cervical biopsy by colposcopy.In the mean time,women with negative in cytological results and with HPV 16 and(or) HPV 18 positive also underwent histo-pathological examination by and colposcopy.The results in two groups were discussed:LCT + HC-Ⅱ group (424 patients) and LCT + PCR12+2 group (421 patients).Results (1) There was no significant difference in cervical intraepithelial neoplasia (CIN) Ⅱ or above disease between LCT + HC-Ⅱ group and LCT + PCR12+2 group (x2 =3.35,P > 0.05).Sensitivity,specificity,positive predictive value and negative predictive value for detection of CIN Ⅱ or above using HC-Ⅱ and PCR12 +2 were 77.8%,79.4%,20.4%,98.1% and 96.3%,78.2%,23.2%,99.7%,respectively.(2) In LCT + PCR12+2 group,it was found 34 women with HPV16 positive,5 women with HPV 18 positive including 1 women combined with HPV 16 positive,74 women with other high risk HPV positive and 309 women with HPV negative.Compared to the infection of other high-risk HPV types,HPV 16 and HPV 18 infection leads to a higher chance of cervical lesions with CIN Ⅱ or above [51.3%(20/39) and 8.1% (6/74)].(3) A significant difference of causing cervical cancer and CIN Ⅱ or above was found among women who were infected with HPV 16 and/or HPV 18 infection,with other high-risk HPV types and negative in high-risk HPV infection (x2 =93.98,P < 0.01).Conclusion LCT combined with PCR genotyping HPV could identify CIN Ⅱ or above disease efficiently.