| Adult females easily suffer from different cervical diseases, which are closely related to pathological progress of cervical canceration. Cervical cancer is a common malignant tumor for women, ranked second position in one of the women in the second of women malignant tumor in China, and its morbidity and mortality in china take first order (about3Q%of this cancer) in world. The number of illness accounts for about a third of the world, and though its reason of this is understood basically, disease is still not clear, a serious threat to women’s life and health, cervical cancer occurrence and development are is a long-term and chronic gradual pathological changes, which follows this process is by that from the early cervical dysplasia (CIN1â†'CIN2â†'CIN3) progressing into carcinoma in situ, terminal infiltrating carcinoma, some needs10years. Such as the nontypical cervical hyperplasia development to carcinoma in situ takes the time more then5years, so the screening and early detection for cervical diseases is an important way of prevention and control of cervical cancer. At present, though there are many methods for the screening, Thin Prep Cytological Test (TCT) is a common and effective method for cervical cancer screening, but because the false positive rate of this method is higher, and so colposcopy can be used to determine clear the abnormal lesion site, and to improve the diagnostic positive rate of diagnosis, but there is the higher rate of missed diagnosis the missed if single colposcopy screening was adopted. The purpose of this study is to understand cervical cancer and precancerous lesions infection, situation through the continuous developing test, discusses and compares diagnostic value between diagnosis only by the cervical Liquid base cytology (Liquid-based cytological test, LTCT) separate and diagnosis by LGT combining with the diagnostic value of colposcopy detection.Methods2416cases of women with cervical diseases were found by medical exrmination in our hospital in2006-2012, aged23-55y, mean age37.1±4.5. They were detected further by adopting new cypress automatic ultrathin liquid base cytology (thinprep cytology test, TCT).According to2001international cancer association recommended TBS cell classification diagnosis system for the specifications for TCT detection, including the specimen satisfactory assessment and unsatisfied specimen to regain, the person is positive classification in cytology TBS colposcopy and cervical biopsy, i.e. above results of ASCUS, should be detected again by expert colposcopy examination in1week. Cervical coated by3%acetic acid and compound iodine solution, such as if epithelial turned white, appear with Mosaic, deformed blood vessels, pitting vitiligo structure, and iodine test (-), it is judged to be abnormal, for more than the other without them belongs to normal state. As long as For vaginal scope mirror image was abnormal line, abnormal spot were taken by multipoint biopsy (a biopsy) and to pathological diagnosis of cervical intraepithelial neoplasia (CIN) class I and the class above it become more were determined as positive. and by pathological report, for chronic inflammation or condyloma-like change sample variable person for was negative,) to pathology diagnosis as the gold standard, and the comparison rates of test coincidence were compared. Results2416cases of patients with cervical lesions,326cases in the abnormal smear, accounting for13.49%. The ASCUS113, LSIL78, HSIL65among326cases, above positive diagnosises were gained by liquid base cytology, but13cases otherwise as for infection and reactive change, which contained kind of condyloma sample lesions in5cases, cases of cell proliferation3, trichomonad, candida, class chlamydia infection together were6cases. No clear significance of diagnosis of atypical squamous cells (ASCUS), low-grade squamous intraepithelial lesions (LSIL) and height in the high-grade squamous epithelial lesions (HSIL) together were57cases. The positive detection rate of cervical low-grade lesions high-risk type HPV was75%. Cervical liquid base cytology took sensitivity of76%, specificity of96%. Pathological biopsy showed cervical squamous cell carcinoma involving gland3, CIN-â… 78, CIN-â…¡56, CIN-â…¢45, chronic inflammation or polyp56, Chronic inflammation with condyloma-like change23, no abnormal change20under colposcope.2416cases of patients with cervical lesions with colposcopy positive cases90cases, histopathological examination positive cases102cases, diagnostic coincidence rate was88.2%(90/102). Colposcopy negative1678cases, histopathological examination negative1690cases, diagnostic coincidence rate was99.2%(1678/1690).This group of patients diagnosed cases of organization learning82cases of carcinoma in situ, infiltrating carcinoma58cases, accounting for5.8%(140/2416). Joint colposcopy positive cases145cases, histopathological examination positive cases164cases, diagnostic coincidence rate was88.9%(145/164).7%of the women were found abnormal change in cervical liquid base cytology in physical examination, of which75%is no clear diagnosis significance of atypical squamous cells (ASCUS), low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous epithelial lesions (HSIL); The results of joint diagnosis, TCT separate diagnosis and histopathological diagnosis were compared:Three kinds of these two later diagnostic methods in cervicitis, CIN1, CIN2, CIN3and infiltrating carcinoma have high diagnostic coincidence rate, in which the highest diagnosis coincidence rate for cervicitis reached to99.8%and for infiltrating carcinoma to100%. These two kinds of diagnostic methods have no significant difference, P>0.05. The coincidence rate of joint diagnosis and pathological diagnosis shows this tendency:infiltrating carcinoma> cervicitis> CIN1> CIN3> CIN2, butthe anomaly image area found by vagina scope mirror were taken to biopsy, which can obviously improve the detection rate of CIN. In three classification of CIN,main changes in vaginal scope image were vascular abnormalities (alien vessel and pitting blood vessels), white epithelia, Mosaic and vitiligo white spot. The relations of HPV virus and level of cervical lesion was analyzed by Spearman rank correlation:the result that every group of CIN1, CIN2, CIN3and cervical carcinoma.A group comparing with NILM shows significant difference, P<0.01, which states viral load of HR-HPV is related to pathogenesis of CIN and cervical carcinoma. There is no significant difference, P>0.05, which states viral load of HR-HPV is not related to change degree of cervical diseases.ConclusionTCT combining colposcopy detection is one of the better means for cervical cancer screening, which is more reliable for distinguishing cervical diseases and has a higher rate of diagnostic coincidence comparing to single TCT diagnosis or single colposcopy detection; viral load of HR-HPV is related to pathogenesis of CIN and cervical carcinoma and not related to change degree of cervical diseases. |
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