| Part ⅠObjective:The study was to explore the diagnostic value of liquid-based cytology test combined with pathological under colposcopy examination for cervical diseases.Methods:In accordance with the established inclusion criteria and exclusion criteria,from November 2014 to July 2017,386 cases of our hospital having TCT,colposcopy histopathological examination of cervical disease patients and 2016 years from November to 2017 In July,104 cases of TCT were examined by colposcopic histopathological examination to screen the results of cervical cancer patients.Results:TCT examination abnormal tissue pathology colposcope positive rate was 42.3%,significantly higher than the histopathological examination and colposcopy simultaneously TCT 17.1%,a significant difference is statistically significant(p<0.05)The specificity and sensitivity of TCT cytology and colposcopic histopathology were 61.9%(198/320)and 90.9%(60/66)respectively.The missed rate was 9.1%(6/66),TCT abnormalities The specificity of histopathological examination was 95.0%(57/60),the sensitivity was 95.5%(42/44),the missed rate was 4.5%(2/44),and its specificity and sensitivity(p<0.05),and the difference was statistically significant(p<0.05).Conclusion:Cervical TCT abnormalities were performed colposcopy histopathological examination than at the same time cervical TCT and colposcopy histopathological examination has a higher diagnostic compliance rate;while the cervical spine TCT and colposcopy histopathological examination,and Did not improve the diagnosis of cervical intraepithelial neoplasia,but increased the patient’s cervical trauma and economic burden.Therefore,cervix TCT cytology abnormalities and then colposcopy histopathology is the current screening and diagnosis of cervical cancer and precancerous lesions of the main means.Part ⅡObjective:Immunohistochemical assay(streptavidin-perosidase)was applied to study PD-L1 expression in chronic inflammation,cervical intraepithelial neoplasia(CIN)and leiomyosarcoma.The correlation between PD-L1 and clinicopathological features was studied to find out their association with the development of cervical cancer,which provided experimental basis for diagnosing and treating cervical precancerous lesions.Therefore,cervical cancer incidence and mortality rates could be reduced by incorporating comprehensive susceptibility group differences and optimal combination screening program.Methods:112 patients(June 2001 to April 2017)were enrolled and paraffin-embedded specimens were collected by surgical resection or biopsy.PD-L1 expression was detected in 48 cervical chronic inflammation,63 cervical intraepithelial neoplasia and 1 leiomyosarcoma patients.The relationship between PD-L1 and clinicopathological features was analyzed together with individual patient data to discover its value in diagnosis and treatment of cervical precancerous lesions.Results:PD-L1 was detected positive among 66.67%of chronic inflammation patients.Its positive rate in the CIN Ⅰ-Ⅱ group was 96.43%and 97.14%in the CIN Ⅱ-Ⅲgroup.Leiomyosarcoma had a negative result.96.83%(61/63)PD-L1 expression in CIN group was significantly higher than that in chronic inflammation group(66.67%)and leiomyosarcoma(0%),which showed statistical significance(p<0.05)Conclusion:Cervical cytology with colposcopic histopathological examination is one of the major methods for screening and diagnosing cervical cancer and precancerous lesions,which can improve the diagnosis of cervical intraepithelial neoplasia and reduce misdiagnosis rate.PD-L1 was seldom expressed in normal cervical tissues,but over-expressed in high-grade lesions.It showed more expression level with the increased lesion degree indicating PD-L1 expression was related to the severity of cervical lesions.In this study,PD-L1 expression analysis by immunohistochemical SP could improve the sensitivity and accuracy of cervical lesions screening,which provided a new biomarker for the examination of cervical lesions. |
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