1.Department of Obstetrics and Gynecology, Wenzhou Centrol Hospital, Wenzhou, 325000; 2.Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027; 3.Department of Pathology, Wenzhou Centrol Hospital, Wenzhou, 325000
ZHANG Aimu,SHEN Qi,ZHAO Jing, et al. Clinical significance of HPV L1 capsid protein detection in cervical exfoliated cell in cervical intraepithelial neoplasm[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(8): 582-585,589.
Abstract：Objective: To explore the clinical significance of HPV L1 capsid protein detection in cervical exfoliated cell in cervical intraepithelial neoplasm in diagnosis and follow up. Methods: Select 276 patients with high-risk human papilloma virus who used to be in Wenzhou Centrol Hospital between January 2013 and June 2013 and the cytological diagnosis was atypical squamous epithelial cell without certain diagnosis significance. All patients accept HPV L1 capsid protein detection in cervical exfoliated cell and colposcope cervical biopsy. Results: ①The expression rate of HPV L1 capsid protein in cytological diagnosis LSIL was up to 70.09% (75/107), followed by ASCUS with the expression rate of 55.46% (66/119), and the expression rate in ASC-H, HSIL, SCC was 10% (5/50) with the significant difference (P<0.05). ②The positive expression rate of HPV L1 capsid protein in CC, CIN I, CIN II-III and SCC was 63.55% (68/107), 75.32% (58/77), 21.59% (19/88), and 0 (0/4) respectively, and there was significant statistical difference (P>0.05). The expression of HPV L1 in CC and CIN I was significantly higher than that in CIN II-III and SCC. ③In high-risk HPV positive women, sensitivity of single TCT inspection and TCT combined with HPV L1 detection on histopathology≥CIN II screening was 46.73% and 88.89%; specificity was 96.20% and 88.65%; positive predictive values were 86% and 71.43%; negative predictive values were 78.32% and 96.15%, respectively. ④In follow-up 31 women with CIN I for 1 year, our fiangdings showed that these two HPV L1 immunostaining results exhibited clearly opposite progression and regression trends that were statistically significant (P<0.05). The sensitivity, specificity, positive predictive values, negative predictive values were 91.67%, 57.89%, 57.89% and 91.67%, respectively. Conclusion: ①The expression rate of HPV L1 capsid protein decreases with the increase of cervical lesions degree; ②In high-risk HPV positive women, TCT combining with HPV L1 detection has higher sensitivity (88.89% vs 46.73%) and negative predictive (96.15% vs 78.32%) than single TCT inspection on histopathology≥CIN II screening; ③It is predicted that there are higher value of sensitivity and negative predictive to predict the spontaneous regression of CIN I of HPV L1 positive ones, which is worth promoting.
