The objective of this study is to guide a triage for the management of cervical high-grade squamous intraepithelial lesion （HSIL） patients with positive margin by conization. Clinico-pathological data of HSIL patien...The objective of this study is to guide a triage for the management of cervical high-grade squamous intraepithelial lesion （HSIL） patients with positive margin by conization. Clinico-pathological data of HSIL patients with positive margin by conization were retrospectively collected from January 2009 to December 2014. All patients underwent secondary conization or hysterectomy within 6 months. The rate of residual lesion was calculated, and the factors associated with residual lesion were analyzed by univariate and multivariate analyses. Among a total of 119 patients, 56 （47.06%） patients presented residual HSIL in their subsequent surgical specimens, including 4 cases of invasive cervical carcinoma （3 stage IA1 and 1 stage IA2 patients）. Univariate analysis showed that patient age 〉 35 years （P = 0.005）, menopausal period 〉 5 years （P = 0.0035）, and multiple- quadrant involvement （P=0.001） were significantly correlated with residual disease; however, multivariate analysis revealed that multiple-quadrant involvement （P=0.001; OR, 3.701; 95%CI, 1.496-9.154） was an independent risk factor for residua! disease. Nearly half of HSIL patients with positive margin by conization were disease-free in subsequent surgical specimens, and those with multiple positive margins may consider re- conization or re-assessment.展开更多
High-grade squamous intraepithelial lesion(HSIL)is regarded as a serious precancerous state of cervix,and it is easy to progress into cervical invasive carcinoma which highlights the importance of earlier diagnosis an...High-grade squamous intraepithelial lesion(HSIL)is regarded as a serious precancerous state of cervix,and it is easy to progress into cervical invasive carcinoma which highlights the importance of earlier diagnosis and treatment of cervical lesions.Pathologists examine the biopsied cervical epithelial tissue through a microscope.The pathological examination will take a long time and sometimes results in high inter-and intra-observer variability in outcomes.Polarization imaging techniques have broad application prospects for biomedical diagnosis such as breast,liver,colon,thyroid and so on.In our team,we have derived polarimetry feature parameters(PFPs)to characterize microstructural features in histological sections of breast tissues,and the accuracy for PFPs ranges from 0.82 to 0.91.Therefore,the aim of this paper is to distinguish automatically microstructural features between HSIL and cervical squamous cell carcinoma(CSCC)by means of polarization imaging techniques,and try to provide quantitative reference index for patho-logical diagnosis which can alleviate the workload of pathologists.Polarization images of the H&E stained histological slices were obtained by Mueller matrix microscope.The typical path-ological structure area was labeled by two experienced pathologists.Calculate the polarimetry basis parameter(PBP)statistics for this region.The PBP statistics(stat PBPs)are screened by mutual information(MI)method.The training method is based on a linear discriminant analysis(LDA)classier whichnds the most simplied linear combination from these stat PBPs and the accuracy remains constant to characterize the specic microstructural feature quantitatively in cervical squamous epithelium.We present results from 37 clinical patients with analysis regions of cervical squamous epithelium.The accuracy of PFP for recognizing HSIL and CSCC was 83.8%and 87.5%,respectively.This work demonstrates the ability of PFP to quantitatively charac-terize the cervical squamous epithelial lesions in the H&E pathological sections.Signicance:Polarization detection technology provides an effcient method for digital pathological diagnosis and points out a new way for automatic screening of pathological sections.展开更多
文摘The objective of this study is to guide a triage for the management of cervical high-grade squamous intraepithelial lesion （HSIL） patients with positive margin by conization. Clinico-pathological data of HSIL patients with positive margin by conization were retrospectively collected from January 2009 to December 2014. All patients underwent secondary conization or hysterectomy within 6 months. The rate of residual lesion was calculated, and the factors associated with residual lesion were analyzed by univariate and multivariate analyses. Among a total of 119 patients, 56 （47.06%） patients presented residual HSIL in their subsequent surgical specimens, including 4 cases of invasive cervical carcinoma （3 stage IA1 and 1 stage IA2 patients）. Univariate analysis showed that patient age 〉 35 years （P = 0.005）, menopausal period 〉 5 years （P = 0.0035）, and multiple- quadrant involvement （P=0.001） were significantly correlated with residual disease; however, multivariate analysis revealed that multiple-quadrant involvement （P=0.001; OR, 3.701; 95%CI, 1.496-9.154） was an independent risk factor for residua! disease. Nearly half of HSIL patients with positive margin by conization were disease-free in subsequent surgical specimens, and those with multiple positive margins may consider re- conization or re-assessment.
基金the Guangming District Economic Development Special Fund(2020R01043)。
文摘High-grade squamous intraepithelial lesion(HSIL)is regarded as a serious precancerous state of cervix,and it is easy to progress into cervical invasive carcinoma which highlights the importance of earlier diagnosis and treatment of cervical lesions.Pathologists examine the biopsied cervical epithelial tissue through a microscope.The pathological examination will take a long time and sometimes results in high inter-and intra-observer variability in outcomes.Polarization imaging techniques have broad application prospects for biomedical diagnosis such as breast,liver,colon,thyroid and so on.In our team,we have derived polarimetry feature parameters(PFPs)to characterize microstructural features in histological sections of breast tissues,and the accuracy for PFPs ranges from 0.82 to 0.91.Therefore,the aim of this paper is to distinguish automatically microstructural features between HSIL and cervical squamous cell carcinoma(CSCC)by means of polarization imaging techniques,and try to provide quantitative reference index for patho-logical diagnosis which can alleviate the workload of pathologists.Polarization images of the H&E stained histological slices were obtained by Mueller matrix microscope.The typical path-ological structure area was labeled by two experienced pathologists.Calculate the polarimetry basis parameter(PBP)statistics for this region.The PBP statistics(stat PBPs)are screened by mutual information(MI)method.The training method is based on a linear discriminant analysis(LDA)classier whichnds the most simplied linear combination from these stat PBPs and the accuracy remains constant to characterize the specic microstructural feature quantitatively in cervical squamous epithelium.We present results from 37 clinical patients with analysis regions of cervical squamous epithelium.The accuracy of PFP for recognizing HSIL and CSCC was 83.8%and 87.5%,respectively.This work demonstrates the ability of PFP to quantitatively charac-terize the cervical squamous epithelial lesions in the H&E pathological sections.Signicance:Polarization detection technology provides an effcient method for digital pathological diagnosis and points out a new way for automatic screening of pathological sections.
