| Objective: Cervical cancer seriously threatens women's life and health,and its prevalence appears younger trend,bringing great burden to women.Cervical cancer is now recognized malignancy with more explicit disease cause.A large number of studies have shown that high-risk human papilloma virus continual infection is the direct cause of cervical cancer.The development from cervical precancerous lesion to cervical cancer takes about5-10 years.Yet the precancerous lesion is not irreversible,so early screening,early detection and treatment can reduce the incidence of cervical cancer.Cervical cancer screening is mainly to detect precancerous lesion and easily overlooked cervical invasive cancer as early as possible.Cervical liquid based cytology significantly reduced the incidence and mortality of cervical cancer.Thin Prep cytology test(TCT)is a common method of screening cervical precancerous lesion and cervical cancer so far.It is a convenient,simple,and noninvasive clinical inspection means.With all collected samples retained and impurities removed,smear quality is improved and clear,well-distributed and easily identified smear can be worked out,which raises the accuracy of diagnosis and satisfaction of cervical cytology smear,and reduces the false negative detection rate.Cervical cytological examination plays an important role in cervical lesion.However,because cervical development,morphology,sizes are different,and cervical lesion is prone to mulifocal,cervical cytology different parts and different methods adopted may affect test results.In this paper,cervical hypertrophy women are regarded as research objects,and cervical hypertrophy is one of the clinical manifestations of cervical precancerous lesions.For women with cervical hypertrophy,the original scale column border can reach the vaginal fornix,leading to a significant expansion of the transformation zone.The diameter of cervical brush used by TCT wasless than the diameter of cervical hypertrophy,and some of the cells in the transformed area were failed to be got,resulting in misdiagnosis.This paper adopted different methods to draw materials,and compared the tests differences caused by the conventional TCT method and the method of enlarging the scope of cervical.It analyzed the effect that two different drawing methods have on the results of TCT,and whether the positive detection rate of our method is high,and whether it has any guiding significance for clinical samples.Method:1 Methods: 88 patients with cervical hypertrophy who were screened for cervical lesion in gynecological clinic of Hebei Medical University second Hospital were selected as subjects.Each patient was followed by the same doctor for two TCT.The first time uses conventional drawing method: insert the cervical brush into the cervical canal,give appropriate pressure,make the cervical brush fan-shaped,make the cervical brush from the cervix of the mouth clockwise rotate for 5 weeks,with its results as the control group.The second time uses the method of expanding the scope of the cervical based for materials drawing,including cervical transformation zone beyond cervical brush due to cervical hypertrophy,the anterior,posterior and lateral fornix,with its TCT examination results as experimental group.The difference of TCT detection results between the two groups,and that of cells number and cell morphology was observed.2 Liquid based cytology and high risk human papillomavirus(HPV)detection were used to screen the cervical lesion of the researchers.The liquid based cytology test report adopts the new TBS classification criteria in 2001.3 SPSS19.0 statistical software was used for statistical analysis.According to the nature of the data,different statistical methods were used:two sample mean comparison t test;multiple sample means comparison variance analysis.Correlation analysis uses Pearson correlation analysis.P<0.05 is taken statistically effective as standard?Results:1.Comparison of the experimental group and control group: 88 subjects in each group.In control group,there are 27 cases of normal TCT results,34 cases of mild inflammation,13 cases of moderate inflammation,13 cases of ASC,1 case of LSIL,and 15.9% positive detection rate.In experimental group,there are 13 cases of normal TCT results,25 cases of mild inflammation,26 cases of moderate inflammation,17 cases of ASC,7 cases of LSIL,and 27.2% positive detection rate.The results of TCT were positive for ASC and above grades.By statistics analysis,chi-square = 15.64,P < 0.05,suggests that the experimental group and control group were statistically different.The positive rate was higher in the experimental group.For women with cervical hypertrophy,the scope expansion of materials drawn when doing TCT screening can increase the detection rate of problem cells,thereby reducing the missed diagnosis.See Table 1.2.Comparison of TCT detection and HPV infection among different age groups: In this paper,the research subject ages from 23 to 73 years old,which is divided into five age groups.The age of high incident abnormal cytology ranges from 40 to 49 years old.Positive examination rate was 33%.It shows that with the increase of age,the incidence of abnormal cytology increases.HPV infection of high incidence age is 40-49 years old.The positive examination rate was 67%.Older women infection rate is low,consistent with the results of cytological examination.Two positive chi-square test were compared,P < 0.05,the difference between groups was statistically effective.The results of TCT detection and HPV infection in different age groups were different.See Table 2.3.Analysis of risk factors for HPV infection: The single factor chi square test was used to examine the influence factors of age,sexual history,menopause,pregnancies times,and delivery times.Tests revealed that all the above factors were statiscally significant except preganancy times.The age,sexual history,menopause and delivery were statistically significant.The statistical significance of the above factors were analyzed by multivariate unconditional Logistic regression analysis.The results showed that age,sexual history,and deliveries times were related to HPV infection(P < 0.05),and the risk factors of HPV infection were older age,longer sexual life and delivery time(OR > 1).See Table 3,4.4.Comparison of samples between the experimental group and the control group: Cytological screening requirements the number of cells up to40000-80000,so as to meet the requirement of each thin film containing 5000well-preserved and clear formed squamous cells.The samples should contain the cervical canal cells or metaplasia cells,which can be used to determine whether or not the transformation zone is taken.The experimental group and the control group were compared at the aspects of the number of cell types,cell types(neck tube cells and metaplastic cells),cell morphology,blood cells and nuclei.The number of cells and cell types of both groups are up to standard.The proportion of red blood cells in the control group was 29.5%,and the proportion of red blood cells in the experimental group was 51%.They were tested by chi square test,P < 0.05,with statistical difference Experimental group contains more blood smear than that of the control group.Affected by the control group,the experimental group does the second time material drawing,which was prone to leading to cervical bleeding.Cell nucleus and cell morphology of abnormal smear ratio of experimental group and control group by chi square test,P < 0.05,the difference was statistically significant.Smear specific rate in the experimental group the is high and the detection rate of problem cells is high.See Table 5.Conclusion: The method that we studied to enlarge the range of cervical materials drawing,can improve the positive rate screening of cervical precancerous lesion.Especially for cervical hypertrophy and cervical erosion high-risk groups,drawing materials for TCT should be comprehensive,particularly the drawing of cervical brush failed to reach cervical tissue.This can reduce the misdiagnosis rate and improve the accuracy of cytological examination. |
PDF Full Text Request