ObjectiveTo investigate the screening value of cervical fluid-based cytology test (TCT), high-risk human papillomavirus (HR-HPV) test, and colposcopy for cervical intraepithelial neoplasia (CIN) and cervical cancer in high-risk populations.
MethodsA total of 466 patients between January 2013 and January 2015 with a history of intercourse bleeding were enrolled in this study, and the screening value of TCT, HR-HPV test and colposcopy for CIN and cervical cancer were retrospectively evaluated.
ResultsIn the 466 patients, 165 were diagnosed with cervical inflammation, 116 with CIN, 182 with grade 2-3 CIN, and 3 with cervical cancer. The colposcopy had the highest sensitivity (84.1%), the lowest specificity (59.4%), high false positive rate (40.6%), low false negative rate (15.9%), and the highest negative predictive value (67.1%). The TCT had the highest specificity (84.8%) and the lowest false positive rate (15.2%). The indicators of HR-HPV were between those of TCT and colposcopy. There were significant differences in terms of these indicators among the three methods (P < 0.05). And the positive prediction value of HR-HPV was the highest (84.5%), while the negative prediction value of colposcopy was the highest (67.1%). There was a significant difference in the predictive value among the three methods (P < 0.05). The consistency of either TCT or HR-HPV alone with pathological diagnosis was poor (K=0.213, 0.343), while that of colposcopy was moderate (K=0.446). Combination of TCT and HR-HPV could significantly improve the diagnosis sensitivity (93.0%) with a lower false negative rate (7.0%); Youden index was 0.736, and the consistency with pathological examination was high (K=0.748).
ConclusionsFor high-risk population with a history of intercourse bleeding or other abnormal cervical disorders, the screening sensitivity of TCT and HR-HPV alone for CIN and cervical cancer is low with a high false negative rate. Colposcopy has a high sensitivity and a low specificity. By combination of TCT and HR-HPV, the validity, reliability and predictive values can be improved significantly, and the sensitivity is high with a low false negative rate and a high consistency with pathological examination.
The study was performed to construct a human cervical cancer cell line C33A which can stably express HPV58E6E7 fusion gene. Firstly, C33A cells were transfected with the recombinant lentivirus LV-HPV58E6E7 which contained HPV58E6E7 fusion gene, and the stably transfected cells (LV-HPV58E6E7/C33A) were screened out by flow cytometry. MTT was used to observe the growth of LV-HPV58E6E7/C33A cells and flow cytometry was carried out to detect the cell cycle. LV-HPV58E6E7/C33A cells were inoculated into the left armpits of nude mice. Then, the transcription and expression of HPV58E6E7 fusion gene was detected by qRT-PCR and Western blot, respectively. The results showed that HPV58E6E7 fusion gene can promote the proliferation of C33A cells. HPV58E6E7 fusion gene can be stably transcripted and expressed in vaccinated nude mice. The conclusion indicated that we successfully established a cervical cancer cell line LV-HPV58E6E7/C33A which can stably express HPV58E6E7 fusion gene. This cell line will provide an antigen cell line for the immune effect detection of HPV58 therapeutic vaccine.
摘要:目的: 探討聯合LCT和高危型HPV檢測對CIN宮頸治療后的隨訪意義。 方法 :對200例LCT異常,高危型HPV陽性,陰道鏡活檢證實為CIN1~3的患者行LEEP治療或宮頸冷刀錐切,治療后進行嚴格隨訪,包括LCT和高危型HPV檢測,陽性病例行組織學檢查。 結果 :(1)所有病例經治療后均無病變殘留,其治愈率為100%。(2)從治療后3個月起,CIN1組高危型HPV轉陰率為100%。在隨訪的第3個月和6個月,CIN2~3組高危型HPV轉陰率分別為7317%和9085%,顯著低于CIN1組,差異有統計學意義(〖WTBX〗P ＜005)。(3)從隨訪12個月起,一直有2例病例持續HPV陽性,均為CIN3患者,但LCT和陰道鏡檢查未發現細胞學異常,繼續隨訪。 結論 :CIN治療后高危型HPV的轉陰時間及轉陰率與CIN的級別有關;高危型HPV持續陽性,但LCT和陰道鏡檢查無異常者可繼續嚴格隨訪;LCT聯合高危型HPV檢測是CIN治療后臨床追蹤隨訪的有效手段。Abstract: Objective: To investigate the Significance of LCT joint highrisk HPV testing for followup after CIN treatment. Methods : 200 cases that highrisk HPV infection were tested by realtime PCR and CIN1~3 were confirmed with LCT and colposcopy biopsy were considered. The patients were treated with LEEP treatment or cold knife conization. After treatment, all cases were strictly followed up with LCT and HPV test, and the patients with positive results were examined by histology. Results : 1) After treatment, there was no residual disease in all cases, the cure rate was 100%. 2) From 3 months after treatment, highrisk HPV negative rate was 100% in CIN1 cases. While at 3rd and 6th month after treatment, highrisk HPV negative rate in CIN2~3 cases were 7317% and 9085%, which were significantly lower than those in CIN1 cases,the difference was statistically significant. 3) From the 12th monthafter treatment, there are still two cases of sustained highrisk HPV positive but normal with LCT and colposcopy biopsy. All cases are still strictly followedup. Conclusion : After treatment, the negative rate and time of highrisk HPV concerned with the grade of the CIN; the patients with persistent positive highrisk HPV, but without abnormalities detected by LCT and colposcopy biopsy could continue to strictly follow up; LCT joint highrisk HPV detection is an effective clinical means for followup after CIN treatment.
