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Background: Cancer cervix is the second most gynaecological and in India, one in fifty women suffer with cancer cervix and hence intense screening is mandatory.Methods: This prospective study was conducted in SVS Medical College, a district tertiary centre. 100 women who presented to gynaecology outpatient department who fulfilled all the inclusion criteria were subjected to pap smear and colposcopic guided biopsy. The data was correlated and compared to critically evaluate the sensitivity and specificity of colposcopy versus Pap smear in the early detection of dysplasia.Results: Colposcopy has far better sensitivity than Pap smear and almost negligible difference in specificity.Conclusions: Colposcopy is definitely more sensitive and accurate than pap smear and can be included as the primary screening in district hospitals as a primary screening tool in detecting cancer cervix.
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Cervical cancer is a kind of malignant tumor that seriously endangers women's health. Cervical cancer has a clear etiology and easy sampling, which can be early detected by screening, and its development can be blocked by early intervention. Cervical cancer screening has been launched for rural women since 2009 in China in order to reduce the incidence of cervical cancer. However, the incidence of cervical cancer has not significantly reduced after ten years. There are three common pain points in the current cervical cancer screening program, including inaccurate sampling, invalid management and no integrated technology. The resolution of these problems will promote the development of cervical cancer screening and the establishment of the long-term mechanism of the prevention and treatment system in China. On the basis of previous studies and in combination with our innovative technologies, we put the observation function of colposcope on the first step for the screening of cervical cancer, which not only ensures accurate sampling, but also further integration of VIA/VILI, HPV typing, liquid-based cytology (TCT) and p16/ki-67 to improve the detection rate of cervical cancer and reduce false negatives. Those women in high-risk groups found by screening can be automatically followed up and given medical advices in the intelligent medical and health management platform for cervical cancer screening. Through repeatedly discussion by expert committee, we put forward expert consensus (2019) for early cervical cancer screening and abnormal crowd management in China. This expert consensus can help doctors in scientific research, clinical practice and the establishment of national policy of cervical cancer screening. We will continuously provide more data to improve cervical cancer screening process in the future.
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Objective: To identify appropriate ways of applying the current cervical screening methods to minimize the occurrence of missed diagnosis of high-grade cervical intraepithelial neoplasia (CIN2/3) and cervical cancer. Methods: A retrospective analysis was conducted based on the clinical data of 318 patients, who had CIN2/3 or cervical cancer and were treated in Aviation General Hospital Affiliated to China Medical University between June 2014 and August 2018. Among these cases, 296 involved CIN2/3, and 22 involved cervical cancer. All of the patients involved underwent a thinprep cytology test (TCT) and high-risk human papilloma virus (hrHPV) screening, and their age and TCT and hrHPV results were further analyzed. Results: Among the 296 patients diagnosed with CIN2/3, 130 of them (43.92%) were aged between 30 and 39 years, ranking the top among all age groups. Sixty-nine young patients (23.31%) aged between 20 and 29 years were diagnosed with CIN2/3, ranking in the third place. Among all of the 318 cases, the TCT results were positive in 199 cases (62.58%), hrHPV results were positive in 308 cases (96.86%), and there were 313 cases (98.43%, 313/318) wherein both TCT and hrHPV results were positive according to joint screening. The most predominant hrHPV subtypes were 16, 52, 58, 33, 18, and 31. Conclusions: As an increasing number of young women are diagnosed with CIN2/3 and cervical cancer, their screening should not be ignored. Single use of TCT screening leads to more frequent missed diagnosis of high-grade lesions compared with single use of hrHPV screening, while joint use of both screening methods could improve the detection rate. Even if TCT results were negative, it is suggested to conduct a colposcopy for those patients with high-risk subtypes besides hrHPV16 and 18 positivity, and in particular, for patients with hrHPV 52,58,33, and 31 positivity.
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Objective To investigate the clinical features and treatment of vaginal intraepithelial neoplasia (VAIN).Methods Clinical data of 50 patients with VAIN,aged 33-76 years,were retrospectively analyzed.Among them,16 patients were diagnosed with grade Ⅰ VAIN,5 with grade Ⅱ VAIN and 29 with grade Ⅲ VAIN.Results A majority of VAIN patients presented with no clinical symptoms,whereas few cases were manifested with increased vaginal secretion.The lesions were located in the vaginal fornix or the upper 1/3 of the vagina in 82％ of patients,and in the middle and lower 1/3 of the vagina in the remaining 18％ cases.Patients with VAIN Ⅰ were observed during follow-up,VAIN Ⅱ patients were given with local administration of medication,and VAIN Ⅲ patients received three-dimensional high-dose rate after loading intracavitary radiotherapy.Human papilloma virus (HPV) infection was positively correlated with VAIN grade (P=0.028).Conclusions The VAIN grade is positively correlated with high-risk HPV infection.Afterloading intracavitary radiotherapy is an efficacious therapeutic approach for VAIN Ⅲ patients,which yields slight adverse events and high cure rate.
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Objective To study the effect of loop electrosurgical excision procedure(LEEP) and colposcope in diagnosis and treatment for cervical intraepithelial neoplasia.Methods A prospective randomized control trail was performed in 116 cervical in traepithelial neoplasia(CIN) patients wederwent LEEP.In 60 patients in the study group,the colposcope definitude locality and distributing of CIN before LEEP.In 56 patients the control group,spread Iodin solution on cervical definitude locality and distributing of CIN before LEEP.Then,follow-up was performed postoperatively in 1,3,6 months respectively.The operation time,the bleeding volume,the rate of residual were compared between the two groups,follow-up CIN.Results The rate of residual in the study group (4/60)6.67 ％ was lower than that in the control group(10/56) 17.86％.There was statistical difference between them(P =0.018).There was no statistical difference between them in the operation time and the bleeding volume( P ＞ 0.05 ).Conclusion With colposcope,Can reduce the rate of residual.
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Oral squamous cell carcinoma is the most common cancer of the oral cavity. The survival rates for oral cancer patients will significantly be improved provided lesions are detected and treated at the infancy stage. Early diagnosis is therefore of paramount importance. Histopathological examination is considered as the gold standard in diagnosing oral lesions. Therefore, the selection for a biopsy site is highly significant. In this article, we present a current review of the colposcope and oral application of the colposcopy technique and its use as an adjunct in the early diagnosis of premalignant and malignant lesions of the oral mucosa. We stress upon the fact that colposcopy (direct oral microscopy) of oral mucosal lesions helps in selecting more representative sites for biopsy than routine clinical examination alone. Because of its precision, versatility, ease of use, and being a non-invasive technique, colposcopy might prove to be a useful step toward continuing to learn and improve the care for our patients.
Subject(s)
Biopsy/methods , Carcinoma, Squamous Cell/diagnosis , Coloring Agents/diagnosis , Colposcopes , Early Detection of Cancer/methods , Endoscopy/methods , Humans , Mouth Neoplasms/diagnosis , Precancerous Conditions/diagnosisABSTRACT
Objective To investigate the diagnosis and treatment of cervical intraepithelial neoplasia and their clinical effect Methods The cases who were diagnosed as CIN through cytology, colposcopy biopsy and histopathological diagnosis were collected from January 2004 to June 2009 in Songjiang Hospital Affiliated to Shanghai Jiaotong University School. Drug therapy, physical therapy, cervical conization and hysterectomy were performed according to the lesion degree of CIN and patients' willingness. Some cases were further treated with surgery, radiotherapy or chemotherapy according to the pathological findings of the initial excision specimens. With long-term follow-up at 6,24 months after the treatment,we performed a comparative analysis on pathological diagnosis and therapeutic effects. Results Seven hundred and fifty cases of CIN were diagnosed after cervical cancer screening,among which,460 cases of CIN Ⅰ ,180 cases of CINⅢⅡ and 110 cases of CIN Ⅲ. Five hundred and Senventy-eight cases received treatment, among which, 46 cases received drug treatment After 6 months, focus disappeared in 32 cases, sustained in 10 cases, upgraded in 2 cases and canceration occurred in 2 cases. 13 cases received physical therapy,no recurrence occured. Four hundred and thirty-five cases received conization treatment, 34 cases with focus upgraded and 4 case recurred after the operation. 84 cases received hysterectomy, of which, 11 cases focus upgraded after the operation and no recurrence. The cases with focus upgraded or recurred all received additional treatment. The effective rate of physical therapy,conization treatment and hysterectomy on all grades of CIN was more than 98% at 2 years, and 69. 7% of drug treatment. The omission diagnostic rate of colposcopy guided biopsy on invasive carcinoma was 2. 2% , and the residual rate of focus of hysterectomy specimens after conization was 16. 2% . Conclusion Colposcopy including multi-point biopsy has high accuracy and specificity in early diagnosis of CIN . Cervical conization is the main method of the treatment of CIN. Patients with CIN Ⅲ and without desire of fertility should consider the removal of the uterus after cervical conization. Drug conservative therapy of CIN should be chosen carefully.
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Objective To investigate the diagnostic value of thinprep cytologic test(TCT) and electronic colposcope(EC) examination in patients with subclinical human papillomavirus(HPV) infection(SPI) and cervical intraepithelial neoplasia(CIN),and explore its concordance with pathologic diagnosis. Methods A total of 1 125 females were examined with TCT,744 of whom diagnosed with abnormality by TCT or suspect of cervical lesions were examined with EC,and multiple punch biopsies were performed in 706 of those with abnomal EC images and suspected diseases. ResultsThe sensitivity of TCT,EC examination and the combined examination of TCT and EC for SPI and CIN were 88.74%,88.79% and 90.63%,respectively,the specificity 85.44%,80.38% and 96.41%,respectively,the positive predictive value 74.06%,68.90% and 91.10%,respectively,and the negative predictive value 94.19%,93.61% and 96.21%,respectively.By the combination of the two examinations,the specificity and positive predictive value were significantly increased(P
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Objective To research on the clinical value of conization of cervix in CINⅢby pathologic histol- ogy with the help of colposcope.Methods 36 cases of CINⅢwere analysed by pathologic histology with the help of colposcope.Results Of all 36 eases diagnosed as CINⅢ,there were 3 cases diagnosed as invasive carcinoma and mi- croinvasive carcinoma.25 cases diagnosed as CINⅢ,8 cases diagnosed as CINⅠ～Ⅱ,and chronic cervicitis after conization of cervix.Conclusion Conization of cervix should be taken for CINⅢby pathologic histology with the help of colposcope.