Reevaluate CIN Ⅰ Diagnosed By Colposcope Directed Biopsy Through LEEP Combining HPV16,18 And TCT

Objective: To reevaluate CINâ… (mild cervical intraepithelial neoplasia ) diagnosed by colposcopically directed biopsy through LEEP(loop electrosurgical excision procedure ) combining HPV16,18-DNA (human papillomavirus 16,18 types-DNA) and TCT (Thinprep cytologic test),to know the accuracy and allsidedness of colposcopically directed biopsy in the diagnosis of CINâ… .Methods: From January 2007 to November 2009, Patients with cervical diseases accepted cytology, HPV16,18-DNA and colposcopy detection in Liuzhou People's Hospital, 90 patients with diagnosed CINâ… by colposcopically directed biopsy and treated by LEEP shortly after were studied,self-control was used to compare and study the results of colposcopically directed biopsy and pathological check after LEEP. Analyze the relationship between different kind of pathologic patterns checked after LEEP and HPV16,18 or TCT .Results: Of the 90 patients, the coincidence was 81.11% between results of colposcopically directed biopsy and pathological check after LEEP. There Were 49 cases of pathological results down-graded to chronic cervicitis accounting 54.44%(49/90),and 24 cases of pathological results remained as CINâ…  accounting 26.67%(24/90),among the 73 cases,there were 16 cases of HPV16,18 positive(21.92%); There were 17 cases of up-graded pathological results accounting 18.89%(17/90),among which,there were 10 cases of CIN II; 7 cases of CINâ…¢(among which, 4 older patients without fertile hope requested to be treated with hysterectomy , the pathological results checked after hysterectomy were 2 cases of CIN II, 1case of CINâ… ,1 case of invasive carcinoma), among the 17 cases ,there were 13 cases of HPV16,18 positive(among which, 6 of CINII and 7 of CINâ…¢) , The differences of positive rate and viral load of HPV16,18 between low grade cervical lesion and high grade cervical lesion are significant(P<0.01) and diseases are worse serious positive rate and viral load of HPV16,18 are higher. The result of cytologic is remarkably associated with pathological check after LEEP. The result of cytologic is worse serious and pathological check after LEEP tend to higher, and there are significant differences between them(P=0.000), the result of cytologic is low while pathological check after LEEP may still find high grade cervical lesion.Conclusion: Miss diagnosis of high grade cervical lesion may still exist on CINâ… by colposcopically directed biopsy. It shoud be alert that there may be existent high grade cervical lesion on the cases being diagnosed CINâ… by colposcopically directed biopsy with cytologic HSIL or HPV16,18 positive. The positive rate and viral load level are associated with cervical lesion degree, detecting them will have important clinical significance to guide the handling of CINâ… . LEEP is more accurately than biopsy on diagnosis of CIN , it is a efficient way to diagnose and treat CIN.