VALUE OF HR-HPV DETECTION IN SCREENING OF CERVICAL LESIONS AND ANALYSIS OF RISK FACTORS OF HIGH-GRADE CERVICAL LESIONS

Panpan Liu¹, Meifang Dou², Li’an Yi³, Kemei Li⁴, Fenghua Yan^5*

¹Department of Ultrasonic Medicine, Qingdao West Coast New Area Traditional Chinese Medicine Hospital (Qingdao Huangdao District Traditional Chinese Medicine Hospital), Qingdao, PR China - ²Department of Emergency, Qingdao West Coast New Area Traditional Chinese Medicine Hospital (Qingdao Huangdao District Traditional Chinese Medicine Hospital) , Qingdao, PR China - ³Department of Health Management Section,Qingdao West Coast New Area Traditional Chinese Medicine Hospital (Qingdao Huangdao District Traditional Chinese Medicine Hospital), Qingdao, PR China - ⁴Department of Nursing, Huangdao community healthcare center, West Coast New District, Qingdao, PR China - ⁵Department of Out-patient, Qingdao West Coast New Area Traditional Chinese Medicine Hospital (Qingdao Huangdao District Traditional Chinese Medicine Hospital), Qingdao, PR China

Objective: To investigate the value of high-risk human papillomavirus (HR-HPV) detection in cervical lesion screening and risk factors for high level cervical lesions.

Methods: A total of 517 women who underwent HR-HPV tests in our hospital from June 2018 to January 2020 were randomly selected. HPV detection and thin-layer liquid-based cytology (TLC) were performed on the patients. The histopathology results were compared with HR-HPV test results, patient age, and HR-HPV test results. The ROC curve was established to analyse the value of HPV detection and TLC in screening cervical lesions, and to analyse the risk factors of high-grade cervical lesions. Risk factors for high-grade cervical lesions were analysed by logistic regression.

Results: The positive rate of HR-HPV was 48.01%, 89.66% and 100.00% in patients with inflammation/cervical intraepithelial neoplasia (CIN) Ⅰ, CIN Ⅱ/CIN Ⅲ and cervical invasive carcinoma, respectively. The positive rate of HR-HPV in patients with CIN Ⅱ/CIN Ⅲ and cervical invasive carcinoma was significantly higher than that in patients with inflammation/CIN Ⅰ (P<0.05). The positive rate of HR-HPV was 67.65%, 66.38%, 66.86%, 52.27% and 75.00% in patients aged 21-29, 30-39, 40-49, 50-59 and ≥59 years, respectively, with no significant difference (P>0.05). Compared with patients with inflammation/CIN I, the positive rate of HR-HPV in patients with CIN Ⅱ/CIN Ⅲ and cervical invasive carcinoma was significantly higher than that in other age groups (P<0.05). The specificity and positive predictive value of HPV detection for cervical lesions was significantly higher than for thin-layer liquid-based cytology and combined detection, and the sensitivity was second only to the combined detection (P<0.05). Under univariate analysis, advanced cervical lesions were not related to number of sexual partners, parity or level of education (P>0.05), but were related to age, age of first sexual intercourse, abortion frequency, HR-HPV and so on (P<0.05). Logistic multivariate regression analysis showed that HR-HPV detection, abortion frequency and age of first sexual intercourse were independent risk factors for high-grade cervical lesions (P<0.05).

Conclusion: HR-HPV detection plays an important role in screening for cervical lesions. HR-HPV detection, abortion frequency and age of first sexual intercourse were independent risk factors for high-grade cervical lesions.