Objective： The aim of the study was to evaluate the clinical value of the video colposcopy in screening cervical intraepithelial neoplasia （CIN） in cytological negative and smooth cervices by optically gynecologica...Objective： The aim of the study was to evaluate the clinical value of the video colposcopy in screening cervical intraepithelial neoplasia （CIN） in cytological negative and smooth cervices by optically gynecological examination. Methods： The 1050 women, whose cervices had been shown smooth and cytological negative by optical examine, were examined with electronic colposcopy in gynecological clinic, and biopsy was taken when the double abnormality of aceto-white epithelium and iodine negative, and other abnormal images were shown. A retrospective analysis of these cases was performed. Re. suits： （1） The 514 samples from 458 cases, including 458 samples of abnormal tissues under colposcopy and 56 samples of polyp or polypoid tumors by optically, were examined by biopsy. Among them, 68 samples were found to be CIN, including 11 cases of CINII/CINIII; （2） The 72 of 1050 cases showed the double-abnormality of aceto-white epithelium and iodine nega- tive. Among them, 64 cases were CIN determined by biopsy. And the positive predictive value of the double-abnormality of aceto-white epithelium and iodine negative under colposcopy was 88.9%, with a false negative rate of 3.3%; （3） Among 458 women examined by biopsy, only one of 350 samples from cervical polyp tissue was CIN （0.3%）, while 67 of 164 samples from the tissues with abnormal colposcopic images were found to be CIN （40.9%）, indicating the close relation between abnormal colposcopic findings and CIN; （4） The results of age-distribution analysis showed that, in the 164 cases with abnormal features under colposcopy, the incidence of double abnormality of aceto-white epithelium and iodine negative was higher in the age of sexual activity, just the same as the age distribution feature of CIN; while single abnormality of iodine negative appeared more in the age of over 50 years. Conclusion： Abnormal features displayed by colposcopy, especially the double abnormality of aceto-white epithelium and iodine negative, has an important significance for the screening of cervical precancerous lesions such as CIN. For this purpose, colposcopy examination is necessary even for the cases of cytological negative and smooth cervices.展开更多
Objective:The paper aimed to study the relationship between the expressions of immunoglobulin G(IgG) subclasses toward human papillomavirus 16-like particles(HPV16VLPs) in the serum of patients and different grades of...Objective:The paper aimed to study the relationship between the expressions of immunoglobulin G(IgG) subclasses toward human papillomavirus 16-like particles(HPV16VLPs) in the serum of patients and different grades of cervical lesions.Methods:The expressions of IgG subclasses in 32 cases of human papillomavirus(HPV) infection,30 cervical intraepithelial neoplasia(CIN I),43 CIN Ⅱ-Ⅲ,and 24 hysteromyoma and chronic cervicitis were examined by ELISA.Results:The absorbance values of HPV16VLPs-IgG,IgG1 increased with the grade of CIN(P < 0.05).The IgG2 dominance(IgG2/IgG1 ratio > 1) from control group was 100%,87.50% for HPV infection group,75% for CIN I group,compared with that from CIN Ⅱ-Ⅲ patients(9.52%)(P < 0.05).The positive rates and absorbance values of HPV16VLPs-IgG,IgG1 and IgG2 from HPV16-DNA positive group were significantly higher than those from non-HPV16-DNA positive group(P < 0.05).There was a moderate correlation between the HPV16-DNA testing and detection of HPV16VLPs-IgG(r = 0.531,P < 0.05).Conclusion:An increase of the expressions of HPV16VLPs-IgG and its subclasses in the serum of the patients with cervical precancerous lesions,especially those with CIN II-III,might be associated with duration of HPV infection and severity of cervical lesions.An increase of the IgG2 dominance(IgG2/IgG1 > 1) in serum from low grade cervical lesions group and normal control group,might indicate the clearance of HPV infection and the regression of cervical lesions.展开更多
Objective: Papanicolou (Pap) smear screening has dramatically reduced the incidence of invasive cervical cancer worldwide. Pap smear screening is still not widely available in developing countries and therefore cannot...Objective: Papanicolou (Pap) smear screening has dramatically reduced the incidence of invasive cervical cancer worldwide. Pap smear screening is still not widely available in developing countries and therefore cannot be used as mass screening tool. This study was designed to establish the role of Pap smear as a routine investigation for females presented to gynecological department. Methods: It was a hospital based study. Patients attending with complaints including irregular vaginal bleeding, vagina discharge, dyspareunia, low backache or lower abdominal pain and primary or secondary infertility were included in the study. All these patients underwent pap smear. Results: Age of females was 25 to 60 years. Ninety females had dysplasia. Mild to moderate dysplasia was positive in 84 females. Six patients had severe dysplasia suspicious for squamous cell carcinoma (SCC) which was confirmed as invasive SCC on biopsy. All patients with mild to moderate dysplasia were regularly followed at 4 to 6 months. Thirty patients were lost during follow up. Forty had negative smear at 6 months, while fourteen having persistent dysplasia on repeated pap smears were referred for biopsies. Histopathology confirmed invasive SCC in five patients while chronic cervicitis was reported in nine patients. Only two of screened patients with high suspicion for cancer showed false negative results. Directed biopsies done in these confirmed invasive SCC. Conclusion: Pap smear is a useful, simple, non-invasive and reliable screening tool for cervical cancer. It may be practiced as a routine investigation in outpatients in developing countries, where mass screening is not available.展开更多
OBJECTIVE: To reduce false-negative rates of population based cervical screening programs employing conventional cytology in combination with automated DNA image cytometer. METHODS: Involved cervical samples from a to...OBJECTIVE: To reduce false-negative rates of population based cervical screening programs employing conventional cytology in combination with automated DNA image cytometer. METHODS: Involved cervical samples from a total of 3603 women were taken by a cervix brush and then placed into a fixative solution. The cells were separated from mucus by mechanical and chemical treatment after which they were deposited onto microscope slides by a cytospin. Two slides were prepared from each case;one slide was stained by Papanicolaou stain for conventional cytology examination, while the other slide was stained by a DNA specific and stoichiometric stain. The latter slide was used to determine the relative amount of DNA in the cell nuclei in order to assess the ploidy status of the epithelial cells. Enrolled in the study, 157 women were followed by colposcopy examination where punch biopsies were taken from the visible lesions or from suspicious areas. The results of the conventional cytology were then compared to the DNA image cytometer for all samples. RESULTS: Histopathology diagnosed 51 lesions from the 132 biopsied cases as CIN2 or higher, including 27 CIN2, 16 CIN3 and 8 invasive cancers. Conventional cytology correctly identified 29 of the 51 high grade CIN and in-vasive cancer, while DNA image cytometer correctly identified 38 high grade CIN and invasive cancer using the crite-rion that at least three cells were found on the slide that contained DNA amount in excess of 5c. 42 out of 51 high grade CIN and invasive cancer were found by conventional cytology in combination with DNA image cytometer. Sensitivities were 56.8%, 74.5% and 82.4%, while specificities were 86.2%, 81.5% and 81.5% in conventional cytology, DNA image cytometer and combination both cytology and DNA image cytometer respectively. CONCLUSION: The study demon-strated that screening for high grade neoplastic lesions and cervical cancer by DNA image cytometer or combination of conventional cytology and DNA image cytometer is more sensitive than conventional screening approach.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
文摘Objective： The aim of the study was to evaluate the clinical value of the video colposcopy in screening cervical intraepithelial neoplasia （CIN） in cytological negative and smooth cervices by optically gynecological examination. Methods： The 1050 women, whose cervices had been shown smooth and cytological negative by optical examine, were examined with electronic colposcopy in gynecological clinic, and biopsy was taken when the double abnormality of aceto-white epithelium and iodine negative, and other abnormal images were shown. A retrospective analysis of these cases was performed. Re. suits： （1） The 514 samples from 458 cases, including 458 samples of abnormal tissues under colposcopy and 56 samples of polyp or polypoid tumors by optically, were examined by biopsy. Among them, 68 samples were found to be CIN, including 11 cases of CINII/CINIII; （2） The 72 of 1050 cases showed the double-abnormality of aceto-white epithelium and iodine nega- tive. Among them, 64 cases were CIN determined by biopsy. And the positive predictive value of the double-abnormality of aceto-white epithelium and iodine negative under colposcopy was 88.9%, with a false negative rate of 3.3%; （3） Among 458 women examined by biopsy, only one of 350 samples from cervical polyp tissue was CIN （0.3%）, while 67 of 164 samples from the tissues with abnormal colposcopic images were found to be CIN （40.9%）, indicating the close relation between abnormal colposcopic findings and CIN; （4） The results of age-distribution analysis showed that, in the 164 cases with abnormal features under colposcopy, the incidence of double abnormality of aceto-white epithelium and iodine negative was higher in the age of sexual activity, just the same as the age distribution feature of CIN; while single abnormality of iodine negative appeared more in the age of over 50 years. Conclusion： Abnormal features displayed by colposcopy, especially the double abnormality of aceto-white epithelium and iodine negative, has an important significance for the screening of cervical precancerous lesions such as CIN. For this purpose, colposcopy examination is necessary even for the cases of cytological negative and smooth cervices.
文摘Objective:The paper aimed to study the relationship between the expressions of immunoglobulin G(IgG) subclasses toward human papillomavirus 16-like particles(HPV16VLPs) in the serum of patients and different grades of cervical lesions.Methods:The expressions of IgG subclasses in 32 cases of human papillomavirus(HPV) infection,30 cervical intraepithelial neoplasia(CIN I),43 CIN Ⅱ-Ⅲ,and 24 hysteromyoma and chronic cervicitis were examined by ELISA.Results:The absorbance values of HPV16VLPs-IgG,IgG1 increased with the grade of CIN(P < 0.05).The IgG2 dominance(IgG2/IgG1 ratio > 1) from control group was 100%,87.50% for HPV infection group,75% for CIN I group,compared with that from CIN Ⅱ-Ⅲ patients(9.52%)(P < 0.05).The positive rates and absorbance values of HPV16VLPs-IgG,IgG1 and IgG2 from HPV16-DNA positive group were significantly higher than those from non-HPV16-DNA positive group(P < 0.05).There was a moderate correlation between the HPV16-DNA testing and detection of HPV16VLPs-IgG(r = 0.531,P < 0.05).Conclusion:An increase of the expressions of HPV16VLPs-IgG and its subclasses in the serum of the patients with cervical precancerous lesions,especially those with CIN II-III,might be associated with duration of HPV infection and severity of cervical lesions.An increase of the IgG2 dominance(IgG2/IgG1 > 1) in serum from low grade cervical lesions group and normal control group,might indicate the clearance of HPV infection and the regression of cervical lesions.
文摘Objective: Papanicolou (Pap) smear screening has dramatically reduced the incidence of invasive cervical cancer worldwide. Pap smear screening is still not widely available in developing countries and therefore cannot be used as mass screening tool. This study was designed to establish the role of Pap smear as a routine investigation for females presented to gynecological department. Methods: It was a hospital based study. Patients attending with complaints including irregular vaginal bleeding, vagina discharge, dyspareunia, low backache or lower abdominal pain and primary or secondary infertility were included in the study. All these patients underwent pap smear. Results: Age of females was 25 to 60 years. Ninety females had dysplasia. Mild to moderate dysplasia was positive in 84 females. Six patients had severe dysplasia suspicious for squamous cell carcinoma (SCC) which was confirmed as invasive SCC on biopsy. All patients with mild to moderate dysplasia were regularly followed at 4 to 6 months. Thirty patients were lost during follow up. Forty had negative smear at 6 months, while fourteen having persistent dysplasia on repeated pap smears were referred for biopsies. Histopathology confirmed invasive SCC in five patients while chronic cervicitis was reported in nine patients. Only two of screened patients with high suspicion for cancer showed false negative results. Directed biopsies done in these confirmed invasive SCC. Conclusion: Pap smear is a useful, simple, non-invasive and reliable screening tool for cervical cancer. It may be practiced as a routine investigation in outpatients in developing countries, where mass screening is not available.
文摘OBJECTIVE: To reduce false-negative rates of population based cervical screening programs employing conventional cytology in combination with automated DNA image cytometer. METHODS: Involved cervical samples from a total of 3603 women were taken by a cervix brush and then placed into a fixative solution. The cells were separated from mucus by mechanical and chemical treatment after which they were deposited onto microscope slides by a cytospin. Two slides were prepared from each case;one slide was stained by Papanicolaou stain for conventional cytology examination, while the other slide was stained by a DNA specific and stoichiometric stain. The latter slide was used to determine the relative amount of DNA in the cell nuclei in order to assess the ploidy status of the epithelial cells. Enrolled in the study, 157 women were followed by colposcopy examination where punch biopsies were taken from the visible lesions or from suspicious areas. The results of the conventional cytology were then compared to the DNA image cytometer for all samples. RESULTS: Histopathology diagnosed 51 lesions from the 132 biopsied cases as CIN2 or higher, including 27 CIN2, 16 CIN3 and 8 invasive cancers. Conventional cytology correctly identified 29 of the 51 high grade CIN and in-vasive cancer, while DNA image cytometer correctly identified 38 high grade CIN and invasive cancer using the crite-rion that at least three cells were found on the slide that contained DNA amount in excess of 5c. 42 out of 51 high grade CIN and invasive cancer were found by conventional cytology in combination with DNA image cytometer. Sensitivities were 56.8%, 74.5% and 82.4%, while specificities were 86.2%, 81.5% and 81.5% in conventional cytology, DNA image cytometer and combination both cytology and DNA image cytometer respectively. CONCLUSION: The study demon-strated that screening for high grade neoplastic lesions and cervical cancer by DNA image cytometer or combination of conventional cytology and DNA image cytometer is more sensitive than conventional screening approach.
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.
