Evaluation value of HPV genotyping and p16/ki-67 double staining for grade Ⅱ or higher intraepithelial neoplasia in women with cervical transformation zone type 3
Objective To analyze the diagnostic value of human papillomavirus(HPV)detection and p16/ki-67 double staining for cervical intraepithelial neoplasia(CIN)Ⅱ or above in women with cervical transformation zone(TZ)type 3.Methods Prospective collection of clinical data on TZ type 3 women who underwent colposcopy examination and large loop exclusion of the transformation zone(LLETZ)treatment in the First Affiliated Hospital of Hebei North University from January 2020 to December 2022.Analyzed and compared the diagnostic value of thin prep cytology test(TCT),HPV detection,endocervical canal curettage(ECC),and p16/ki-67 double staining in CIN Ⅱ+before LLETZ.The sensitivity,specificity,positive predictive value,and negative predictive value of different diagnostic methods for predicting histological diagnosis of CIN Ⅱ+were calculated.And McNemar test were used to compare different diagnostic methods.Results A total of 101 patients who received LLETZ treatment,of which 51(50.5％)had CIN Ⅱ+.Among 37 HSIL patients,28(75.7％)had CIN Ⅱ+;among 64 LSIL patients,23(35.9％)had CIN Ⅱ+.82.1％of women infected with HPV 16 had CIN Ⅱ+,but only 45.1％of women of CIN Ⅱ+infected with HPV 16.The positive predictive value of CIN Ⅱ+in high-risk HPV predictive diagnosis was only 60.7％,and the negative predictive value was 100％.The negative predictive value of p16/ki-67 double staining examination was 100％,and the positive predictive value was 79.7％.In LSIL women,p16/ki-67 cytological double staining predicted a higher positive predictive value for CIN Ⅱ+compared to high-risk HPV(76.1％vs.35.9％),while in HSIL women,ECC double staining improved the positive predictive value for high-risk HPV(96.5％vs.75.7％).Conclusion The p16/ki-67 double staining can improve the predictive efficacy of routine screening for CIN Ⅱ+in TZ 3 type women,which is helpful for better monitoring of cervical conditions in TZ 3 type women.
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