Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2022; 10(34): 12543-12550
Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12543
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
Yun-Chun Chen, Department of Laboratory Medicine, Haikou Branch of Yueyang Integrative Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Haikou 570216, Hainan Province, China
Chong-Nan Liang, Department of Laboratory Medicine, Haikou Hospital of Traditional Chinese Medicine, Haikou 570216, Hainan Province, China
Xiang-Feng Wang, Min-Fa Wang, Xu-Ning Huang, Department of Ultrasound Medicine, Second Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Jian-Dong Hu, 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
Author contributions: Chen YC, Liang CN, and Hu JD conceived and designed the experiments; Wang XF and Wang MF performed the experiments; Huang XN analyzed and interpreted the data; Chen YC, Liang CN, and Hu JD contributed reagents, materials, and analysis tools or data and wrote the paper.
Supported by the Hainan Provincial Natural Science Foundation of China, No. 822RC870 and No. 819MS148.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Second Affiliated Hospital of Hainan Medical University (Approval No. HKSZYYYLL-2022-08).
Conflict-of-interest statement: All the authors declare that they do not have a conflict of interest.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Informed consent statement: The informed consent was waived from the patinets.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Dong Hu, MD, Doctor, 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), No. 45 Jinpan Road, Haikou 570216, Hainan Province, China. hamlethu@163.com
Received: June 19, 2022
Peer-review started: June 19, 2022
First decision: July 29, 2022
Revised: October 16, 2022
Accepted: November 17, 2022
Article in press: November 17, 2022
Published online: December 6, 2022
Processing time: 165 Days and 22.3 Hours
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, ThinPrep cytology test screening, Human papillomavirus, Follow-up study, Screening, Tropical regions

Core Tip: In China, 75000 new cases of cervical cancer occur every year, and 33000 people died of cervical cancer in 2008. The progression from human papillomavirus infection to cervical cancer can take years, offering a unique opportunity to prevent cancer. Our study of 206 cervical cancer screening-positive cases revealed a tendency to transform squamous epithelial lesions to glandular epithelial lesions and an improvement of the disease. The human papillomavirus test indicated a high negative conversion ratio of the viral infection, and persistent infection of high-risk human papillomavirus was not detected. Early intervention of cervical cancer screening is necessary.