Pathological Analysis Of Cervical Intraepithelial Neoplasia After Cervical Conization

Objective:To investigate the pathological results coincidence rate before and after surgery that may lead to pathological changes through the analysis of the pathological results after surgery for cervical intraepithelial neoplasia,explore reasonable clinical treatment of cervical intraepithelial neoplasia.Methods: Collect 446 cases from July 2014 to July 2015 that have been visited in Qingdao University hospital,all patients in our hospital underwent colposcopy and cervical biopsy,including 351 cases for cervical cold knife conization(CKC),95 cases for loop electrosurgical procedure(LEEP).The results of pathological examination were retrospectively analyzed,and the consistency of pathological results was compared with preoperative and postoperative pathological results.Then from the the Bethesda system(TCT)?squamous cell antigen(SCC-Ag)?the type of colposcopy?endocervical curettage(ECC)?P16?pathological grade and lesions and other perspective that may lead to the change of pathological results.Results:1.Those TCT negative patients,the postoperative pathological include cervicitis(9person),CIN(41 person).When the results of TCT were typical squamous cells ?low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions,the detection rate of CIN was not statistically significant(P > 0.05),but for LSIL and HSIL patients,the preoperative and postoperative compliance was statistically significant(P < 0.05).2.The pathological coincidence rate of type 1 and type 2 in the conversion zone of colposcopy was higher than type 3,but there was no statistically significant.3.The results of colposcopy and cervical biopsy combined with ECC detection were higher than that of cervical biopsy under colposcopy(P<0.05).When ECC was negative,the rate of pathological degradation was higher than that of ECC(P<0.05).When ECC was positive,the rate of pathological enhancement was higher than that of ECC(P<0.05)4.The postoperative pathological coincidence rate of CINII was lower than CINIII,the coincidence rate was statistically significant.The application of LAST scheme can improve the pathological coincidence rate.5.When the scope of lesions under colposcopy biopsy was a single point of focus,the rate of postoperative reduction was 40%,the coincidence rate was 50%,and the rate of escalation was about 10%.With the increase of the number of cervical lesions,the pathological coincidence rate was increased(P<0.05),and the degradation rate was decreased.6.P16 was expressed differently in different degree of cervical lesions,and the positive rate increased gradually with the aggravation of the disease.The expression of P16 in CINII was high,and the shunt effect of CINII was weak,and the shunt effect was not good.The P16 negative group was two,the difference between the two groups was not statistically significant(P > 0.05).7.There was no significant difference in cervicitis,CINI,CINII,CINIII and early cervical cancer(IA1)of SCC-Ag.Conclusion:1.If the TCT results was negative,the cervical lesions can not be excluded.If the result of TCT was LSIL,the pathological coincidence rate was lower than that of HSIL.2.In this study,there was no significant difference in the prognosis of CIN after the operation.The result showed that there was no significant difference between the two types.3.Colposcopy biopsy combined with ECC detection can improve the diagnostic accuracy rate,the ECC results can be useful for the prediction of postoperative pathological changes.4.If the results of cervical biopsy under colposcopy were CINII,the pathological coincidence rate was lower than that of CINIII.The new method can improve the pathological coincidence rate before and after operation.5.The results of colposcopy biopsy and cervical lesions were significant for predicting postoperative pathological changes.6.The shunt effect of P16 on CINII is weak,and its value in the diagnosis of cervical lesions needs a large sample of clinical verification.7.In cervical cancer(IA1)and the following lesions,SCC-Ag value is not significant to predict the pathological changes after CIN.