Abstract:

Objective To investigate the role of human papillomavirus（HPV） DNA typing combined with "three-ladder" screening program [high-risk（HR）-HPV DNA typing+thinprep cytologic test（TCT）→colposcopy→cervical histopathological diagnosis] in large scale samples for cervical cancer screening. Methods A total of 9 033 women were enrolled in experimental group for cervical cancer screening. HR-HPV DNA was determined firstly. According to "three-ladder" screening program,women with positive HPV16 and HPV 18 subtypes and women over 45 years old were performed for TCT→colposcopy→cervical histopathological diagnosis. Women with other positive subtypes were followed up. Totally,2 448 women were enrolled in control group,and HR-HPV DNA typing+TCT→colposcopy→cervical histopathological diagnosis were performed. Results The positive rate of HR-HPV DNA in experimental group was 7.82%（706/9 033）. There were 365 cases determined by TCT+colposcopy,and 119 cases were diagnosed by cervical histopathological diagnosis. The rate of HR-HPV DNA positive and TCT≥atypical squamous cell of undetermined significance（ASCUS）/atypical glandular cell of undetermined significance（AGUS） was 2.57%（63/2 448） in control group. There were 63 cases determined by colposcopy,and 39 cases were diagnosed by cervical histopathological diagnosis. The detection rates of high-grade squamous intraepithelial lesion（HSIL） and cervical cancer were 0.17%（15/9 033） in experimental group and 0.16%（4/2 448） in control group. There was no statistical significance between the 2 groups（P>0.05）. Conclusions HPV DNA typing combined with "three-ladder" screening program is a simple,economical and convenient way to manage HPV-positive patients in large scale samples. It is worthy of promotion.

Key words: Human papillomavirus DNA typing, Cervical cancer, Screening, Prognosis