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 ...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.展开更多
Objectives: To evaluate the predictive value of cervical intraepithelial neoplasia (CIN)III/ carcinoma in situ (CIS) by correlating analysis between abnormal cervical cytologic findings and pathological diagnosis of v...Objectives: To evaluate the predictive value of cervical intraepithelial neoplasia (CIN)III/ carcinoma in situ (CIS) by correlating analysis between abnormal cervical cytologic findings and pathological diagnosis of vaginoscopic biopsies or conization.Methods: Routine cervical cytology screening was performed in 31,634 cases by fluid-based thin-layer method (ThinPrep cytology test, TCT), 948 patients had both abnormal squamous cell appearance by TCT and pathological diagnosis of vaginoscopic biopsies and /or cervical conization. The predictive value of CINIII/CIS were studied retrospectively by correlating analysis of different cytology abnormalities and pathology diagnosis.Results: Cytologically, 1,260 out of 31,634 TCT tests showed abnormal squamous cells appearance, including atypical squamous cell of undetermined significance (ASCUS) 675 cases(2.13%), low squamous intraepithelial lesion (L-SIL) 379 cases(1.20%), high squamous intraepithelial lesion (H-SIL)176 cases(0.56%),cancer 30 cases (0.09%). Among 948 patients with pathological diagnosis, there were CINII-III in 70 cases(7.38%) and CINIII/CIS in 56 cases.(5.91%). The relative risks (RR) of different precancerous TCT results in predicting CIN III/CIS validated by pathology are as follow: AUSCUS 14.7% (95% confidence interval (CI) 8.0-27.0), Lsil 13.9% (95% CI 6.3-30.9), Hsil 126.1 (95% CI 60.6-218.6). The RR of AUSCUS group is not significantly different from that of L-SIL group(P =0.951). However, the RR of CINⅢ/CIS morbidity between the H-SIL or cancer group and the ASCUS or L-SIL group are significantly different (all P value <0.01).Conclusion: Vaginoscopic biopsy could verify pathological CINⅡ-Ⅲ and CINⅢ/CIS from cases with abnormal TCT results. There is significantly greater risk of being CINⅢ/CIS validated by vaginoscopic biopsy in the H-SILpatients,while ASCUS and L-SIL group have the coequal risk.展开更多
目的探讨高危型人乳头瘤病毒(HR-HPV)DNA聚合酶链反应(PCR)联合液基薄层细胞学检查(TCT)对宫颈癌前病变筛查的应用与诊断价值。方法对540例TCT结果为非典型鳞状上皮细胞(ASCUS)及以上的患者进行HR-HPV DNA PCR检测,并对检测结果进行分...目的探讨高危型人乳头瘤病毒(HR-HPV)DNA聚合酶链反应(PCR)联合液基薄层细胞学检查(TCT)对宫颈癌前病变筛查的应用与诊断价值。方法对540例TCT结果为非典型鳞状上皮细胞(ASCUS)及以上的患者进行HR-HPV DNA PCR检测,并对检测结果进行分析。结果 TCT阳性合并HPV阳性患者共259例,其中ASCUS、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)、鳞状细胞癌(SCC)的例数(阳性率)分别为155例(59.8%)、81例(31.3%)、15例(5.8%)、8例(3.1%);259例患者中ASCUS、LSIL、HSIL、SCC合并HR-HPV的阳性例数(阳性率)分别为28例(18.1%)、20例(24.7%)、10例(66.7%)、8例(100.0%)。HR-HPV和TCT单独检测的敏感性与两者联合检测的敏感性比较,差异具有统计学意义(P<0.05)。HR-HPV、TCT及两者联合检测的阳性预测值分别为25.5%、11.1%、28.2%,阴性预测值分别为68.8%、59.2%、40.8%。结论TCT与HR-HPV DNA PCR检测是筛查宫颈病变的有效方法,能最大程度地发现宫颈异常细胞并及时发现宫颈癌的诱因。展开更多
基金Supported by the Hainan Provincial Natural Science Foundation of China,No.822RC870 and No.819MS148.
文摘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.
文摘Objectives: To evaluate the predictive value of cervical intraepithelial neoplasia (CIN)III/ carcinoma in situ (CIS) by correlating analysis between abnormal cervical cytologic findings and pathological diagnosis of vaginoscopic biopsies or conization.Methods: Routine cervical cytology screening was performed in 31,634 cases by fluid-based thin-layer method (ThinPrep cytology test, TCT), 948 patients had both abnormal squamous cell appearance by TCT and pathological diagnosis of vaginoscopic biopsies and /or cervical conization. The predictive value of CINIII/CIS were studied retrospectively by correlating analysis of different cytology abnormalities and pathology diagnosis.Results: Cytologically, 1,260 out of 31,634 TCT tests showed abnormal squamous cells appearance, including atypical squamous cell of undetermined significance (ASCUS) 675 cases(2.13%), low squamous intraepithelial lesion (L-SIL) 379 cases(1.20%), high squamous intraepithelial lesion (H-SIL)176 cases(0.56%),cancer 30 cases (0.09%). Among 948 patients with pathological diagnosis, there were CINII-III in 70 cases(7.38%) and CINIII/CIS in 56 cases.(5.91%). The relative risks (RR) of different precancerous TCT results in predicting CIN III/CIS validated by pathology are as follow: AUSCUS 14.7% (95% confidence interval (CI) 8.0-27.0), Lsil 13.9% (95% CI 6.3-30.9), Hsil 126.1 (95% CI 60.6-218.6). The RR of AUSCUS group is not significantly different from that of L-SIL group(P =0.951). However, the RR of CINⅢ/CIS morbidity between the H-SIL or cancer group and the ASCUS or L-SIL group are significantly different (all P value <0.01).Conclusion: Vaginoscopic biopsy could verify pathological CINⅡ-Ⅲ and CINⅢ/CIS from cases with abnormal TCT results. There is significantly greater risk of being CINⅢ/CIS validated by vaginoscopic biopsy in the H-SILpatients,while ASCUS and L-SIL group have the coequal risk.
文摘目的探讨高危型人乳头瘤病毒(HR-HPV)DNA聚合酶链反应(PCR)联合液基薄层细胞学检查(TCT)对宫颈癌前病变筛查的应用与诊断价值。方法对540例TCT结果为非典型鳞状上皮细胞(ASCUS)及以上的患者进行HR-HPV DNA PCR检测,并对检测结果进行分析。结果 TCT阳性合并HPV阳性患者共259例,其中ASCUS、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)、鳞状细胞癌(SCC)的例数(阳性率)分别为155例(59.8%)、81例(31.3%)、15例(5.8%)、8例(3.1%);259例患者中ASCUS、LSIL、HSIL、SCC合并HR-HPV的阳性例数(阳性率)分别为28例(18.1%)、20例(24.7%)、10例(66.7%)、8例(100.0%)。HR-HPV和TCT单独检测的敏感性与两者联合检测的敏感性比较,差异具有统计学意义(P<0.05)。HR-HPV、TCT及两者联合检测的阳性预测值分别为25.5%、11.1%、28.2%,阴性预测值分别为68.8%、59.2%、40.8%。结论TCT与HR-HPV DNA PCR检测是筛查宫颈病变的有效方法,能最大程度地发现宫颈异常细胞并及时发现宫颈癌的诱因。
