Effect of HPV detection and cervical cell basis detection on early diagnosis of cervical precancerous lesions

Objective To analyze the effect of human papillomavirus (HPV) detection and cervical cell basal fluid on the early diagnosis of cervical precancerous lesions. Methods From January 2016 to January 2017, 223 patients in the Maternal and Child Health Care Hospital of Yongkang who received gynecological cervical cancer precancerous lesions screening were selected.All patients into the outpatient screening categories were given cervical liquid-based cytology (TCT) examination and HPV detection, 61 patients with test results of double positive received colposcopy cervical biopsy histopathological examination, the final diagnosis of 49 patients with epithelial cell changes.The accuracy and sensitivity of different detection methods were compared. Results The detection rates of high risk HPV infection in cervicitis, CINⅠ, CINⅡ-CINⅢ and cervical cancer patients were 16.22%, 39.29%, 71.43% and 100.00% in 223 cases of this study.The total positive rate of TCT was 28.57%.The total positive rate was 44.44% in HPV group and 75.51% in combination test.The positive rate of combined detection was higher than TCT (χ2=21.63, P=0.000) and HPV (χ2=25.51, P=0.000), the difference was statistically significant.For ASC patients, the sensitivity of TCT, HPV and combined detection was 57.14%, 64.29% and 85.71%, respectively.The accuracy of TCT, HPV and combined detection was 64.29%, 71.43% and 92.86%, respectively.The sensitivity of combined detection was similar to TCT (χ2=2.13, P=0.140) and HPV (χ2=1.25, P=0.260). The accuracy of combined detection was similar to TCT (χ2=2.33, P=0.130) and HPV (χ2=1.39, P=0.240). For LISIL patients, the sensitivity of TCT, HPV and combined detection was 56.25%, 62.50% and 87.50%, respectively, the accuracy was 68.75%, 75.00% and 93.75%, respectively.The sensitivity of the combined test group was higher than that of TCT (χ2=3.86, P=0.049) and HPV (χ2=4.57, P=0.033), and the accuracy of combined test was higher than that of TCT (χ2=3.902, P=0.048) and that of HPV (χ2=4.13, P=0.034). For HISIL typing patients, the sensitivity of TCT, HPV and combined detection was 57.89%, 63.16% and 89.43%, respectively, and the accuracy was 73.68%, 78.95% and 94.74%, respectively.The sensitivity of the combined test group was higher than that of TCT (χ2=4.89, P=0.027) and that of HPV (χ2=3.99, P=0.047), and the accuracy of combined test was higher than that of TCT (χ2=3.99, P=0.048) and that of HPV (χ2=5.34, P=0.027). Conclusion High-risk HPV detection combined with TCT in the screen of cervical cancer precancerous lesions is simple and efficient, taking into account the accuracy and sensitivity, it can reduce the rate of missed diagnosis, has a positive effect on prevention and control of cervical cancer. Key words: Human papillomavirus; Cervical cell basal fluid detection; Cervical precancerous lesions; Early diagnosis