Follow-up study on ThinPrep cytology test-positive patients in tropical regions

Yun-Chun Chen; Chong-Nan Liang; Xiang-Feng Wang; Min-Fa Wang; Xu-Ning Huang; Jian-Dong Hu

doi:10.12998/wjcc.v10.i34.12543

Follow-up study on ThinPrep cytology test-positive patients in tropical regions

World J Clin Cases. 2022 Dec 6;10(34):12543-12550. doi: 10.12998/wjcc.v10.i34.12543.

Authors

Yun-Chun Chen¹, Chong-Nan Liang², Xiang-Feng Wang³, Min-Fa Wang³, Xu-Ning Huang³, Jian-Dong Hu⁴

Affiliations

¹ Department of Laboratory Medicine, Haikou Branch of Yueyang Integrative Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Haikou 570216, Hainan Province, China.
² Department of Laboratory Medicine, Haikou Hospital of Traditional Chinese Medicine, Haikou 570216, Hainan Province, China.
³ Department of Ultrasound Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China.
⁴ Department of Internal Medicine, Haikou branch of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Shanghai University of Traditional Chinese Medicine (Haikou Hospital of Traditional Chinese Medicine), Haikou 570216, Hainan Province, China. hamlethu@163.com.

Abstract

Background: As shown in the statistics from the World Health Organization, it is estimated that approximately 75000 new cases of cervical cancer occur every year in China. In 2008, 33000 people died of cervical cancer in China. It is proven that most women are at risk of cervical cancer. The progression from human papillomavirus (HPV) infection to cervical cancer can be several years or decades, which offers a unique opportunity to prevent cancer.

Aim: To observe the changes in ThinPrep cytology tests (TCT) and HPV infection in patients who were detected to be positive via TCT screening of cervical cancer and further explore the biopsy results.

Methods: This paper performed a follow-up study on 206 cervical cancer screening-positive patients of 12231 total cases from our previous research. We conducted an observational study on the TCT results based on the interpretation of The Bethesda System.

Results: Over a 5-year period, 10 cases received consistent follow-up. The proportions of cases in which glandular epithelial lesions were detected increased over the follow-up period. The differences between the years were statistically significant (P < 0.01). Over the 5 years, the proportion of patients whose squamous epithelial lesions transformed into glandular epithelial lesions increased yearly. Annual positive rates of HPV infection were: year 1, 73% (24/33); year 2, 43% (6/14); year 3, 36% (9/25); year 4, 50% (9/18); and year 5, 25% (6/24). The positive detection rate after biopsy over a 9-year period was 29%.

Conclusion: The follow-up study for 5 years to 9 years revealed a tendency to change from squamous epithelial lesions to glandular epithelial lesions and an improvement of the disease (which had not been reported previously). The HPV test indicated a high negative conversion ratio of the viral infection. However, the follow-up cases were not found to have persistent infection of high-risk HPV. Therefore, early intervention of cervical cancer screening is necessary. Low re-examination compliance, patient education, and preventive measures should be enhanced.

Keywords: Cervical cancer; Follow-up study; Human papillomavirus; Screening; ThinPrep cytology test screening; Tropical regions.