Study On The Diagnosis Of Cervical Intraepithelial Neoplasia By Combining Acetic Acid White Test, Histopathology And Ki67 And P63 Expression

ACETIC ACID WHITE TEST COMBINED WITH PATHTHOLOGICAL HISTOMORPHOLOGY IN CLINICALL VALUE IN DIAGNOSIS OF CERVICAL INTRAEPITHELIAL NEOPLASIAObjective:This article through studies the ways to diagnose by visual inspection with acetic acid test and pathological histomorphology. And analyses the reason of their incoincident rate, combines with visual inspection with acetic acid test and pathological histomorphology, to achieve the goal of improving cervical cancer detection rate.Methods:Selecting 87 cases outpatients from Guangxi medical university affiliated tumor hospital in July 2008 to July 2010, which is the implementation of cervical cancer early detection of outpatient cases cervical lesions treated early project women from the ministry of health and China cancer foundation, the aged from 30 to 59 years old, the median age of 42. The above cases are no cervical acute inflammation, avoid the menstrual period, there is no history of cervix and uterus related operation and the history of chemotherapy. To avoid the subjectivity in the process of reading, two deputy director of the above title of doctors who are experienced trained from the department of the gynaecology and pathology, diagnose of results. And then based on the level of lesion group, namely inflammation group, CIN I group, CIN II group and CIN Ⅲ/set of carcinoma in situ group. Fistly, each of the above cases do visual inspection with acetic acid test (VIA) by colposcope, geting a preliminary diagnosis, then with pathological histomorphology check again, that is the final confirmed. Analyse not coincidence rate of the two kinds of methods respectively in the diagnosis of cervical lesions, explore the bias reseason in the aspect of pathological tissue morphology.Results:Acetic acid white test under colposcope diagnose inflammatory 22 cases, CIN I level 33 cases, CIN II 26 cases and CIN grade Ⅲ/6 cases of carcinoma in situ. Diagnosed with inflammation pathological histomorphology, 41 cases CIN I level 25 cases, CIN II 18 cases and CIN grade Ⅲ/carcinoma in situ (3 cases). Two kinds of detection methods in inflammation group, CIN I level group, CIN II level group and CIN grade Ⅲ/not coincidence rate of carcinoma in situ group were 46.34%,32.00%,44.44% and 46.34% respectively, chi-square= 9.288, p< 0.05, the difference was statistically meaning. Acetic acid white test to diagnose the cervical intraepithelial neoplasia resulted in a larger bias, lead to this method to diagnose the cervical diseases more severe than the examination in the diagnosis of pathological tissue morphology.Conclusions:To diagnose the larger bias during the cervical intraepithelial neoplasia with the means of VIA and the pathological histomorphology,which the main reason is the cervical disease expressing the diversity of pathological morphological performance in different levels. combined the two methods can improve the accuracy of cervical cancer screening.THE SIGNIFICANCE OF EXPRESSION OF KI67 P63 IN CERVICAL INTRAEPITHELIAL NEOPLASIAObjective:To explore the comprehensive diagnosis of cervical intraepithelial neoplasia baced on the acetic acid white test by colposcope and pathological tissue morphology, further research the relationship between the Ki67 and p63 protein expression and cervical lesions.Methods:Selecting 222 cases samples, including 87 cases patients from Guangxi medical university affiliated tumor hospital in July 2008 to July 2010, which is the implementation of cervical cancer early detection of outpatient cases cervical lesions treated early project women from the ministry of health and China cancer foundation, and 135 cases of the department of pathology archive wax block specimen,the aged from 30 to 59 years old, the median age of 42.The above cases without resection of the cervical cone line, history of uterine or total resection surgery, chemotherapy, radiation therapy, such as processing. To reduce the subjectivity in the process of jugement, by the deputy director above title of doctor of the department of pathology, doing two experienced trained double-blind diagnosis, and then according to the level of lesion group, namely inflammation group, CIN I group, CIN II group and CINIII/carcinoma in situ group. Ki67 and p63 were detected by immunohistochemical to observe both in inflammation and different levels of expression of intraepithelial neoplasia and analyzed the relationship between them. Then use rank and inspection, Spearman rank correlation method for the data statistical analysis.Results:1-.222 cases of specimens were divided into the inflammation group 87 cases, CIN I group 37 cases, CIN II group 50 cases and CIN Ⅲ/in situ carcinoma group 48 cases with pathologic diagnosis. According to the different morphologies,87 cases of inflammation group can be divided into ordinary inflammation group 38 cases, squamous metaplasia group 20 cases (with squamous group) and mucosal epithelial thickening of single hyperplasia +epithelial foot stretch group 29 cases (group with epithelial foot stretch). Ki67 was set in cell nucleus by immunohistochemy, presented with yellow to tan. Ki67 was lower expression in inflammation group and was high expression in CIN groups, and its expression enhanced with the growth level of cervical lesion (p< 0.05). p63 was also located in the nucleus via immunohistochemy, characterized by deep yellow to tan. p63 was lower expression in the common inflammation group, and was high expression in squamous metaplasia group (with squamous group), mucosal epithelial thickening of simple hyperplasia +epithelial foot stretch group and the CIN groups (p< 0.05),which express enhance with the increased level of CIN.2、Ki67 and p63 protein expressed in the tissue of cervical lesions were positively correlated (rs= 0.791, p< 0.05).Conclusions:1、Ki67 and p63 protein expressed in the inflammation and CIN group, had statistical meaning between groups, and there were positively correlated between cervical inflammation and cervical intraepithelial neoplasia. It showed that there are closely linked during Ki67、p63 and development of cervical intraepithelial neoplasia.2、Combined pathological morphology+ acetic acid white test (VIA)+Ki67 counting cell proliferation index, is practical and accurate method in diagnosis and differential diagnosis of CIN.