Clinical significance of combined detection of thinprep cytology test and high risk human papillomavirus hybrid capture 2 assay in the screening and recurrence predication of cervical intraepithelial neoplasia

OBJECTIVE: To evaluate the clinical significance of combined detection of TCT and HR-HPV-HC2 assay in the screening and recurrence prediction of CIN. METHODS: A total of 725 patients with suspected cervical abnormalities received TCT plus HR-HPV-HC2 detection and histopathological examinations.203 CINII-III patients received TCT and HC2 detection and histopathological examinations after treated with loop electrosurgical excision procedure or cold knife conization operation. The results of pathological examinations were gold standard. The sensitivity and specificity of TCT, HR-HPV-HC2 and TCT plus HR-HPV-HC2 were analyzed. RESULTS: The missed diagnosis and misdiagnosis rate of TCT and HC2 alone were 19.23%, 12.50% and 48.15%, 74.07% and sensitivity and specificity 90.02%, 97.01% and 51.85%, 17.76% respectively. The sensitivity, missed diagnosis rate and negative predictive value were 98.25%, 1.75% and 89.70% when TCT or HR-HPV-HC2 met the CIN diagnostic criteria. The specificity and positive predictive value were 58.95% and 72.80% when TCT and HR-HPV-HC2 met the CIN diagnostic criteria. The specificity of TCT or HR-HPV-HC2 alone was 80% for the prediction of recurrence at Month 6 postoperation. The specificity of TCT plus HR-HPV-HC2 was 98.27% for the prediction of recurrence at Month 3 postoperation and the negative predictive value was 98.75% at Month 6 postoperation. The sensitivity of TCT or HR-HPV-HC2 was 97.22% for the prediction of recurrence at Month 3/6. And the negative predictive value was 99.17% at Month 6 postoperation. CONCLUSION: The combined detection of TCT and HR-HPV-HC2 may improve the sensitivity and specificity of CIN and the predication of its postoperative recurrence.