Do you understand some of the HPV detection errors?

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Cervical cancer is the second most common cancer in women worldwide, and is the most common malignancy in women in Africa, Asia and South am

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Cervical cancer is the second most common cancer in women worldwide, and is the most common malignancy in women in Africa, Asia and South america. Its incidence and mortality are second only to breast cancer. Every year, there are about 131 thousand and 500 women with newly diagnosed cervical cancer in China, with the death rate of about 53 thousand, and the number of new cases accounting for about 30% of the world. High risk HPV infection is an important cause of cervical cancer and cervical precancerous lesions. High risk HPV detection can effectively improve the detection sensitivity of cervical precancerous lesions and significantly reduce the missed diagnosis rate, which has become an important method for cervical cancer screening. Due to the numerous HPV detection methods, the design of various detection methods, the principle and clinical positive threshold settings and other factors, many female friends of the detection of HPV there are some misconceptions.

Myth: detection of low-risk HPV has clinical value

Low risk HPV is generally associated with condyloma acuminatum or low-grade squamous intraepithelial lesions, the clinical value of detection is not clear. Therefore, the detection of low risk HPV can not play the role of cervical cancer screening is a misunderstanding.

Myth two: HPV detection is to find the virus

80% of women are likely to be infected with HPV during their lifetime, most of which are transient infections that can be removed by the immune system and thus do not produce lesions, which means that the infection is not the same as the disease. Therefore, HPV detection is used to detect cervical lesions [such as cervical intraepithelial neoplasia (CIN) 2+] patients, rather than to find the virus with or without! This increase.

Myth three: the higher the value of HPV quantitative detection, the more serious the lesions

Two generation hybrid capture (the hybrid capture, HC2) HPV detection technology using relative light unit / clinical threshold (RLU/CO, relative units/cut off light) detection of high-risk HPV. As long as HPV positive (RLU/CO = 1), regardless of RLU/CO levels, which can lead to cervical cancer and CIN. There was no absolute correspondence between the HPV value and the severity of the disease.

Error four: the results of different HPV detection technology should be the same

Clinically, there are many HPV detection products. Because of the difference of the detection target gene fragment, the method and the HPV subtype, the detection results of different products can be different.

Myth five: HPV is a necessary condition for the occurrence of cervical cancer, HPV negative cervical cancer will not occur

HPV negative may also be diagnosed with cervical cancer. A special type of cervical cancer is possible as minimal deviation adenocarcinoma of the cervix carcinoma, and endometrial serous carcinoma, clear cell carcinoma with HPV infection; on the other hand, any kind of HPV detection methods have some false negative rate, current screening methods are still unable to achieve 100% sensitivity and specificity.

Myth six: 90%HPV infection is a transient, within 1 to 2 years to clear

2. The clearance rate of 91% was limited to women aged under the age of 30, with a transient infection of between 79% and 30 of women aged 80% years. HPV infection rate with age but, when young women unable to remove the HPV into persistent infection stage, persistent infection in women increases with age increased, it is more meaningful to HPV detection of older or sexual life long time women were the reason why.

Myth seven: HPV detection applies to all women

Clinically, HPV should be avoided for women aged 30 years, especially in women aged, who should be screened for HPV at the time of cytology ASC-US. One reason: women of this age group had the highest HPV infection rate, but most of them (91%) cleared the virus within 2 years. Two reasons: cervical cancer is more common in women above the age of 40, sustained high-risk HPV infection to cervical cancer takes a long time, from the development of invasive CIN cancer generally takes 10 to 15 years, but about 25% of patients within 5 years of the development of invasive cancer. Women over the age of 30 can be used either cytology screening or HPV screening, of course, cytology and HPV combined with the highest screening efficiency.

Chinese Journal of Practical Gynecology and obstetrics, 2016 fifth

 

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