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
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
目的检测Beclin-1、LC3-Ⅱ在宫颈病变组织及HPV感染中的表达,并探讨其临床意义。方法选取昆明医科大学第二附属医院妇科2014年10月至2016年6月的行宫颈癌筛查(HPV、TCT)的患者,筛查结果任意一项异常患者均行宫颈活检,最终选取病检结果...目的检测Beclin-1、LC3-Ⅱ在宫颈病变组织及HPV感染中的表达,并探讨其临床意义。方法选取昆明医科大学第二附属医院妇科2014年10月至2016年6月的行宫颈癌筛查(HPV、TCT)的患者,筛查结果任意一项异常患者均行宫颈活检,最终选取病检结果为正常的宫颈组织40例(其中HPV感染20例,无HPV感染20例);CINⅠ30例;CINⅡ/Ⅲ30例;年龄范围为25～55岁;妊娠及已行宫颈治疗过的患者不纳入研究范围。用Western Blot法检测正常宫颈组织、CINⅠ及CINⅡ/Ⅲ组织中Beclin-1、LC3-Ⅱ相对表达量。结果 (1)Beclin-1在正常的宫颈组织、CINⅠ及CINⅡ/Ⅲ组织中的相对表达量分别为(0.561±0.041)、(0.421±0.018)、(0.351±0.016);LC3-Ⅱ在正常宫颈组织、CINⅠ及CINⅡ/Ⅲ组织中的相对表达量为(0.683±0.027)、(0.435±0.029)、(0.325±0.017);Beclin-1、LC3-Ⅱ在3组间的相对表达量差异有统计学意义(P <0.001);Beclin 1,LC3-Ⅱexist in the relative expression between the 3 group were statistically significant (P <0.001)(2)病检结果为正常的宫颈组织中HPV感染组中Beclin-1和LC3-Ⅱ的相对表达量均显著低于无HPV感染组(P <0.05)。结论随着宫颈病变级别的增加,自噬相关基因Beclin-1、LC3-Ⅱ的相对表达量呈下降趋势,提示自噬基因活性下降或缺失可能参与宫颈癌的进展。展开更多
Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 （LSIL/CIN1） preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separat...Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 （LSIL/CIN1） preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus （HPV） 16/18 genotyping in 273 patients with LSIL/CINI. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV （hrHPV） were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases （69.6%） regressed, 37 （13.6%） persisted, and 46 （16.8%） progressed. HPV16/18 positivity （hazard ratio （HR）, 2.708; 95% confidence interval （CI）, 1.432-5.121; P=-0.002） is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.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.
文摘目的检测Beclin-1、LC3-Ⅱ在宫颈病变组织及HPV感染中的表达,并探讨其临床意义。方法选取昆明医科大学第二附属医院妇科2014年10月至2016年6月的行宫颈癌筛查(HPV、TCT)的患者,筛查结果任意一项异常患者均行宫颈活检,最终选取病检结果为正常的宫颈组织40例(其中HPV感染20例,无HPV感染20例);CINⅠ30例;CINⅡ/Ⅲ30例;年龄范围为25～55岁;妊娠及已行宫颈治疗过的患者不纳入研究范围。用Western Blot法检测正常宫颈组织、CINⅠ及CINⅡ/Ⅲ组织中Beclin-1、LC3-Ⅱ相对表达量。结果 (1)Beclin-1在正常的宫颈组织、CINⅠ及CINⅡ/Ⅲ组织中的相对表达量分别为(0.561±0.041)、(0.421±0.018)、(0.351±0.016);LC3-Ⅱ在正常宫颈组织、CINⅠ及CINⅡ/Ⅲ组织中的相对表达量为(0.683±0.027)、(0.435±0.029)、(0.325±0.017);Beclin-1、LC3-Ⅱ在3组间的相对表达量差异有统计学意义(P <0.001);Beclin 1,LC3-Ⅱexist in the relative expression between the 3 group were statistically significant (P <0.001)(2)病检结果为正常的宫颈组织中HPV感染组中Beclin-1和LC3-Ⅱ的相对表达量均显著低于无HPV感染组(P <0.05)。结论随着宫颈病变级别的增加,自噬相关基因Beclin-1、LC3-Ⅱ的相对表达量呈下降趋势,提示自噬基因活性下降或缺失可能参与宫颈癌的进展。
基金Project supported by the Zhejiang Provincial Natural Science Foundation of China(No.LQ14H160007)the National Natural Science Foundation of China(No.81402364)+2 种基金the Zhejiang Provincial Medical & Hygienic Science and Technology Project of China(No.2013KYA104)the Special Fund for Scientific Research in the Public Interest from the National Health and Family Planning Commission of the People’s Republic of China(No.2015SQ00243)the National Key Research and Development Program of China(No.2016YFC1302900)
文摘Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 （LSIL/CIN1） preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus （HPV） 16/18 genotyping in 273 patients with LSIL/CINI. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV （hrHPV） were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases （69.6%） regressed, 37 （13.6%） persisted, and 46 （16.8%） progressed. HPV16/18 positivity （hazard ratio （HR）, 2.708; 95% confidence interval （CI）, 1.432-5.121; P=-0.002） is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.
