摘要
目的探讨采用经宫颈环形电切术(loop electrosurgical excision procedure,LEEP),对阴道镜检查为宫颈Ⅲ型转化区异常部位多点活检宫颈组织病理学诊断为宫颈上皮内瘤变(cervicalintraepithelial neoplasias,CIN)Ⅰ,对漏诊宫颈高级别病变(宫颈上皮内瘤变Ⅱ,Ⅲ)的预测价值。方法选取2007年1月至2009年10月于江苏省人民医院宫颈病中心就诊,宫颈脱落细胞学结果示≥不明意义非典型鳞状细胞(atypical squamous cell of undetermined significance,ASCUS),高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)呈阳性,阴道镜检查为宫颈Ⅲ型转化区活检组织病理学诊断为宫颈上皮内瘤变Ⅰ患者79例为研究对象。对其采取经宫颈环形电切术后行组织病理学检查,比较阴道镜多点活检与经宫颈环形电切术后组织病理学检查结果变化,分析术前宫颈脱落细胞学及高危型人乳头瘤病毒载量与经宫颈环形电切术后组织病理学结果相关性(本研究遵循的程序符合江苏省人民医院人体试验委员会所制定的伦理学标准,得到该委员会批准和受试对象本人的知情同意,并与之签署临床研究知情同意书)。结果①79例阴道镜下多点活检组织病理学结果为宫颈上皮内瘤变Ⅰ,经宫颈环形电切术后组织病理学诊断结果升级率为53.16%(42/79),其中宫颈上皮内瘤变Ⅱ为22例,宫颈上皮内瘤变Ⅲ为18例,宫颈癌ⅠA1期为2例。②术前宫颈脱落细胞学级别与宫颈病变程度呈正相关(P<0.05),但一致性较差(Kappa=0.1247)。③高危型人乳头瘤病毒载量与宫颈病变程度无相关性(P>0.05)。结论阴道镜检查为宫颈Ⅲ型转化区多点活检组织病理学诊断宫颈上皮内瘤变Ⅰ级存在高级别病变漏诊风险,术前宫颈脱落细胞学对诊断有一定参考价值,但对高危型人乳头瘤病毒载量预测价值不大。
Objective To discuss the predicting value of cervical intraepithelial neoplasias （CIN） Ⅰwith type Ⅲ transformation zone （TZ） had high grade cervical lesion. Method From January 2007 and October 2009, 79 cases who were diagnosed as cervical intraepithelial neoplasias Ⅰby histopathology in the People＇s Hospital of Jiangsu Province were recruited into this study. The cervical cytological examination showed ≥atypical squamous cell of undetermined significance （ASCUS）, and high-risk human papilloma virus（HR-HPV） is positive. The histopathology was conducted after the loop electrosurgical excision procedure （LEEP）, and histopathology changes were compared between colposcopic site-specific biopsies and loop electrosurgical excision procedure. Histopathological correlation were compared among preoperational cervical cytology, high-risk human papilloma virus load and loop electrosurgical excision procedure. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of People＇s Hospital of Jiangsu Province. Informed consent was obtained from all participants. Result （1）F or 79 cases, 53. 16% （42/79, 53. 16%） cervical intraepithelial neoplasias Ⅰ was graded up after loop electrosurgical excision procedure with 22 cervical intraepithelial neoplasias Ⅱ, 18 cervical intraepithelial neoplasias m and 2 cervical cancer Ⅰ Al. （2）The cytology positively correlated with the grade of cervical lesion （P〈0.05）, but not accordant （Kappa： 0.1247）. （3）The viral load of high-risk human papilloma virus was not correlated with the grade of cervical lesion （P〉0.05）. Conclusion Cervical intraepithelial neoplasias Ⅰ with type Ⅲ transformation zone is prone to omission of high-grade intraepithelial lesion. The cytology may help to predict the grade of cervical lesion. But the predicting value of high-risk human papilloma virus on the grade of cervical lesion may be inadequate.
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2011年第2期105-108,共4页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
关键词
宫颈上皮内瘤变Ⅰ级
宫颈Ⅲ型转化区
高危型人乳头瘤病毒
细胞学
cervical intraepithelial neoplasias （CIN） Ⅰ, type Ⅲ transformation zone, high risk human papilloma virus（HR HPV） , cytology
