Application of liquid-based cytology and high-risk human papillomavirus DNA detection in cervical lesion screening

Objective: To explore the application of liquid-based cytology test (LCT) and high-risk human papillomavirus (HR-HPV) DNA test in cervical lesion screening.

Methods: A retrospective analysis was conducted in 4264 patients with LCT, among whom 621 patients had colposcopic biopsy and HR-HPV test for atypical squamous cells of undetermined significance (ASCUS and over).

Results: Of the 621 patients, 388 were identified to have ASCUS, 147 had low-grade squamous intraepithelial lesions (LSIL), 75 had high-grade squamous intraepithelial lesions (HSIL) and 11 had squamous cell carcinomas (SCC). Comparison of the diagnostic results of LCT and histopathology diagnosis suggested a rate of agreement of 72.41% (147/203) for LSIL, 92.60% (75/81) for HSIL, and 100% (11/11) for SCC. The infection rate of HR-HPV was 43.32%(269/621) in the 621 patients, 100.00% (11/11) in SCC patients, 84.85% (28/33) in CIN III patients, 70.83% (34/48) in CIN II patients, 84.073 (172/203) in CIN I patients, 7.32% (24/326) in patients with normal cervix/cervicitis, indicating increased rate of HR- HPV infection with aggravation of cervical lesion. The sensitivity and specificity of LCT test were 81.04% and 91.64% respectively, and those of HR-HPV were 90.47% and 93.14 respectively.

Conclusions: The combination of LCT and HR-HPV DNA test increases the sensitivity and specificity of diagnosis in cervical dysplasia, and may help in better prophylaxis and treatment of cervical carcinoma.