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Introduction: Cervical cancer is a public health problem, and tracking of the disease must follow a set of organized programmed actions, with populations and periodicity defined. Objective: Identifying the prevalence of intraepithelial lesions in preventive examinations performed in the municipality of Sinop-MT between 2010 and 2013. Methods: Statistical data obtained using the DATASUS/SISCOLO system were used. Results: When considering the descriptive diagnosis for cellular alterations, 412 and 167 altered exams with low- and high-grade intraepithelial lesions (respectively) were found. The prevalence of both low-grade (25.45%) and high-grade (10.32%) intraepithelial lesions were higher outside of the recommended age range (25-64 years). Conclusions: Studies on the prevention of cervical cancer are extremely relevant in order to analyze the coverage of screening in areas served by basic health units and to understand the factors associated with non-adherence of women to preventive examination. It is noteworthy that during the time period analyzed, women in the municipality of Sinop did not fulfill the municipal goal.(AU)
Introdução: O câncer do colo do útero é um problema de saúde pública e o rastreamento dessa doença deve seguir um conjunto de ações programadas, organizadas com populações e periodicidade definidas. Objetivo: este estudo teve como objetivo identificar a prevalência da lesão intraepitelial em exames preventivos coletados no município de Sinop-MT, entre 2010 e 2013. Métodos: Estudo retrospectivo realizado no Município de Sinop. Os dados utilizados foram obtidos por meio do sistema DATASUS/SISCOLO, entre 2010 e 2013. As variáveis analisadas foram: número de exames citopatológicos dentro dos limites de normalidade, lesão intraepitelial de baixo grau (LIBG) e lesão intraepitelial de alto grau (LIAG) e faixa etária de 25 a 64 anos. Resultados: ao considerar o diagnóstico descritivo para alterações celulares, foram constatados 412 e 167 exames alterados com lesão intraepitelial de baixo e alto grau, respectivamente. Tanto a prevalência de lesão intraepitelial de baixo grau (25,45%), quanto de alto grau (10,32%), foram maiores fora da faixa etária preconizada (25 a 64 anos). Portanto, estudos sobre a prevenção do câncer do colo do útero são de extrema relevância, a fim de analisar a cobertura do rastreamento em áreas atendidas pelas unidades básicas de saúde e compreender os fatores associados à não adesão das mulheres à realização do exame preventivo. Conclusão: Ressalta-se que o município de Sinop nos quatros anos analisados não cumpriu a meta municipal.(AU)
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Uterine Cervical Dysplasia , Uterine Cervical Diseases , Disease PreventionABSTRACT
Objective To study the clinical treatment methods for properties of unknown in elderly patients with atypical squamous cell of undertermind significant and above cervical lesions.Methods According to the clinical grouping of ASCUS in elderly patients with cervical lesions of different treatment methods,observation group 1 (348 cases) underwent colposcopy;observation group 2(316 cases) for high-risk human papillomavirus(HPV) detection,HPV positive colposcopy ;observation group 3 (129 cases) of cervical cytology examination regularly,squamous intraepithelial lesion colposcopy,compared three groups of clinical treatment.Results Liquid based cytology and three groups of 574 patients (TCT) and colposcopy and cervical biopsy,the results of intraepithelial neoplasia(C IN) above cervical lesions in 223 cases(38.9%),in which CIN Ⅰ 136 cases(23.7%),CIN Ⅱ in 64 cases(11.2%),CIN Ⅲ 20 cases(3.5%),3 cases of carcinoma in situ(0.5%) ;the group1 were observed in 348 cases,348 cases underwent colposcopy biopsy(100%),CIN Ⅱ above 36 cases(10.3%) were observed in the group 2;213 cases of colposcopy biopsy(67.4%),CIN Ⅱ above 38 cases (12%) were observed in the group 3 ; colposcopy examination in 13 cases (10.1%),3 cases of biopsy CIN Ⅱ of the cases(2.3%).Biopsy of CIN Ⅱ above the detection rate,the observation group 1,observation of the 2 groups had no significant differences(P ＞ 0.05),and observe the difference between the 3 groups was statistically significant(x2 =7.014,9.156,all P ＜ 0.05).Conclusion High-risk HPV detection of shunt ASCUS can reduce cervical lesions treatment process misdiagnosis,missed diagnosis and treatment of the problem of excessive.
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Objective To study the clinical application value of TCT technology in prevention and screening cervical lesions.Methods 9 582 cases received TCT detection. The positive patients received further biopsy vaginal endoscopy. Results In 9 582 specimens, there were 392 abnormal smear including 311 ASC (3.24％) ,45 LSIL (0.47％) ,13 HSIL(0. 13％ ),21 AGC(0. 22％ ),1 SCC(0. 01％ ). The 35 ～39 age group had the highest positive rate(20. 92％ ) and the 30～35 age group was prior(20. 66％ ) in the positive group. The coordination rate between TCT and biopsy endoscopy was 58. 67％. The coordination rates for ASC, LSIL, HSIL, AGC, SCC were 54. 98％ ,80. 00％, 100. 00％ ,42. 86％, 100. 00％ respectively. The effect of TCT on the positive coordination rate of upper HSIL was higher than lower HSIL( x2 =9. 810,P =0. 002). Conclusion The combination of TCT and biospy endoscope was an effective method to screen the early cervical cancer.
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Objective To assess the value of LEEP for diagnosis and treatment in patients with cervical lesion.Methods 128 patients with cervical lesion were treated by LEEP.The transformation zohe of the cervix was completely excised in every case.All specimens after LEEP were sent for pathological diagnosis.The duration of the management,the amount of bleeding,the complains of the patients as well as the close follow up after treatment were all noted and recorded in detail.Results The procedure time of LEEP was short and about 6.2 minutes without anesthesia.The bleeding of LEEP was 8.4ml,the complications were few and the cure rate was high.Conclusion LEEP is safe and effective method in treatment of cervical diseases.Standardization of operation procedure and the follow-up can get satisfactory effects.
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Objective To study the expressions of main subtypes of heat shock protein (HSP) in uterine cervix with different pathological changes. Method 478 cases of cervical biopsy specimen were divided into invasive carcinoma of cervix group (63 cases), cervical intraepithelial neoplasia group (CIN, 106 cases), chronic cervicitis group (293 cases) and normal uterine cervix (16 cases) according to pathological diagnosis. The expression levels of HSP70, HSP90α and HSP90β mRNA were detected by quantitative RT-PCR with specific complex cRNA as internal control. Results (1) The expressions of HSP70, HSP90α and HSP90β mRNA were significantly downtrend stepwise in invasive carcinoma of cervix, CIN, chronic cervicitis and normal cervix tissue. (P＜0.01, respectively). (2)In the invasive carcinoma of cervix group, the expression level of HSP90β mRNA was higher in advanced stage (FIGOⅡb-Ⅳ) compared with incipient (FIGOⅠa-Ⅱa) cancer of the cervix. (P＜0.05). (3)The expressions of HSP70 and HSP90β mRNA were each higher in poorly differentiated tumor than in well-differentiated tumor. (P＜0.05, respectively). (4)The expression levels of all three HSP mRNA had no significant differences were observed with different histological types of cervical cancer. (P＞0.05). Conclusions Heat shock protein may play some important roles in malignant transformation of cervix cell and aggravation of cervix cancer. HSP70 and HSP90α may promote cancer cell transition and proliferation, and HSP90β may participate in cell differentiation.
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0.05).The cytological false negative rate was 23.58% for LSIL,17.57% for high squamous intraepithelial lesion(HSIL),0.00% for squamous cell cancer(SCC),and 50.00% for adeno-carcinoma(AC);the false positive rate was 14.29% for LSIL and 3.85% for HSIL.Conclusion Liquid-based cytology test is an effective method for the screening of cervical cancer and precancerous lesion.The high-quality cervical cell specimen is important to ensure the diagnosis accuracy.
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Objective To evaluate the high-risk human papillomavirus(HR-HPV)detection and thinprep cell test(TCT)in the diagnosis of cervical lesion by comparison with pathological findings.Methods The data collected from Dec.2004 to Dec.2006 from 690 patients who had undergone HR-HPV detection,TCT and pathology examination with electronic colposcopy in the Department of Obstetrics and Gynecology,General Hospital of PLA were analyzed retraspactively.Results Among the 690 patients,the coincidence between the findings of TCT and pathology was 22.34%(42/188)for low-grade squamous intraepithelial lesion(LSIL),58.33%(56/96)for high-grade squamous intraepithelial lesion(HSIL)and 100%(16/16)for cervical cancer.The number of patients with the cytological diagnosis of abnormal squamous cells(ASC),LSIL,HSIL and cervical cancer was 315,188,96 and 16,respectively.Among them,the positive rate of HR-HPV of ASC,LSIL,HSIL and cervical cancer was 53.96%(170/315),77.12%(134/188),80.21%(77/96)and 100%(16/16),respectively.Pathologic examination through electronic colposcopy revealed the number of patients with the diagnosis of inflammation,CINⅠ/HPV,CINⅡ/CINⅢ and invasive cancer was 425,81,157 and 27,respectively.Among them,the positive rate of HR-HPV in inflammation was 43.29%(184/425),CINⅠ/HPV 74.93%(60/81),CINⅡ/CINⅢ 91.72%(144/157)and invasive cancer 92.5%(25/27).Among the 690 cases,413 were HR-HPV positive,55.45%(229/413)of which showed CINⅠ/HPV or higher.277 cases were HR-HPV negative,and 87.01%(241/277)of which showed inflammation,12.99%(36/277)of which showed CINⅠ/HPV or higher,and 5.42%(15/277)of which showed CINⅡ/CINⅢ and invasive cervical cancer.Among 315 cases with ASC,170 cases were HR-HPV positive,41.76%(71/170)of which showed CINⅠ/HPV or higher,including 69.01%(49/71)CINⅡ/CINⅢ and invasive cervical cancer.145 cases were HR-HPV negative,only 4.83%(7/145)of which was CINⅡ/CINⅢ and invasive cervical cancer,and 90.34%(131/145)of which was inflammation.Conclusion HR-HPV detection and TCT are feasible for cervical lesion screening.Cytology combined HR-HPV test is favorable for shunting management in cervical lesions.
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Objective To study the accuracy and efficiency of video colposcopy in diagnosis of cervical squamous intraepithelial lesions and clinical significance of seven colpocopic signs. Methods Two handred and senventy five patients with an abnormal cervical smear or vulva condyloma acuminata were re evaluated by video colposcopy. 265 cervical biopsies performed under the guidance of video colposcopy for pathological study, as well 8 endocervical curettage (ECC) and 237 loop electrosurgical excision procedure (LEEP). Results The sensitivity, specificity and positive rate of video colposcopy in evaluation of cervical squamous intraepithelial lesions were 95 9%, 77 7%, and 84 5%. Video colposcopy diagnostic accuracy was 93 8% tally with the pathological results in observing normal transformation zone. False negative rate was 6 1%. 76 2% of cases with subclinical papillomavirus infection by acetowhite epitheliun, while false negative rate was 23 7%. Twin signs, triple signs and cervical carcinoma were 100 0% tallying with the diagnosis of cervical lesions. Conclusions Video colposcopy can be a very accurate diagnostic method in clinical practice. It is quite sensitive in diagnosis of severe cervical lesions. However, there was a relative high false negative rate in diagnosing mild cervical lesions.