ABSTRACT
Objective:To analyze the situation of free cervical cancer screening from 2018 to 2020 in Lucheng District of Changzhi City, Shanxi Province.Methods:The cervical liquid-based thin-layer cytology (TCT) results of 13 043 women who underwent free cervical cancer screening at the Lucheng District Maternal and Child Health Family Planning Service Center of Changzhi City in Shanxi Province from 2018 to 2020 were retrospectively analyzed. The women with positive TCT results underwent colposcopy and biopsy.Results:Among 13 043 women, 800 women were positive for TCT, with a positive rate of 61.3/100 000. The positive rates of cervical cancer screening TCT in 2018, 2019 and 2020 were 4.82% (145/3 006), 5.63% (170/3 017) and 6.91% (485/7 020), which showed an upward trend year by year (contingency coefficient = 0.037). In 2018, 2019 and 2020, the positive rates of TCT among women aged 35-44 years old were 2.95% (31/1 052), 3.78% (42/1 112) and 4.22% (82/1 969), among women aged 45-54 years old were 5.48% (68/1 241), 6.50% (90/1 385) and 7.72% (2 258/3 341), and among women aged 55-64 years old were 6.45% (46/713), 7.31% (38/520) and 8.42% (144/1 710); the positive rates of cervical cancer screening TCT among different age groups in the same year, same age group in different years and overall different age groups in 3 years were statistically significant (all P < 0.05), and the positive rates of cervical cancer screening TCT in women aged 45-54 and 55-64 years old were higher than those in women aged 35-44 years old (all P < 0.05). Among 800 cases of positive cervical cancer screening TCT, 615 cases (76.9%) were diagnosed with cervical intraepithelial neoplasia (CIN), and the incidence rate of CIN was 4.72% (615/13 043); there was statistical differences in the incidence of CIN among different years ( P < 0.05). Conclusions:The positive rates of cervical cancer screening increase year by year from 2018 to 2020 in Lucheng District of Changzhi City, Shanxi Province. Early cervical cancer screening can detect cervical lesions in time.
ABSTRACT
Objective The loop electrosurgical excision procedure (LEEP) is a major option for the treatment of cervical in-traepithelial neoplastic (CIN) lesions,but reports are rarely seen on the consistency of the result of post-LEEP pathology with that of preoperative biopsy as well as on the postoperative pathological upgrading of related factors. This study analyzes the consistency of the result of preoperative biopsy with that of post-LEEP pathology for CIN lesions and the risk factors for residual and/or recurrence after LEEP. Methods A retrospective study was conducted on 1 089 patients with CIN lesions treated by LEEP in our hospital from May 2014 to A-pril 2017. All the patients underwent liquid-based thin-layer cytology (TCT) and vaginoscopic biopsy preoperatively,followed by analysis of the results of TCT,the consistency of the result of preoperative bi-opsy with that of post-LEEP pathology,and the risk factors for residu- al and/or recurrence after LEEP. Results Preoperative biopsy showed 447 cases of low-grade squamous intraepithelial lesion (LSIL),among which TCT revealed 85 cases negative for intraepithelial lesion and malignancy (NILM),with a false negative rate of LSIL of 19.0%. Of the 645 cases of high-grade squamous intraepithelial lesion (HSIL) revealed by preoperative biopsy,TCT manifes-ted 95 cases of NILM,with a false negative rate of HSIL of 14.7%,which was significantly lower than that of LSIL (P<0.05). Preop-erative biopsy showed 447 cases of LSIL,among which post-LEEP pathology manifested 316 cases of LSIL (70.69%) and 51 cases of HSIL (11.4%). Of the 635 cases of HSIL revealed by preoperative biopsy,post-LEEP pathology exhibited 4 cases (0.63%) of inva-sive cervical cancer (ICC). Multivariate analysis showed the risk factors for pathological upgrading after LEEP were sexual partners >2 (OR=0.139,95% CI: 0.034-0.561) and LSIL in TCT (OR=0.111,95% CI: 0.040-0.310) (P<0.05) and those for postopera-tive recurrence included positive incision margin (OR=2.970,95% CI: 1.010-8.733) and persistent human papilloma virus (HPV) infection (OR=5.446,95% CI: 3.109-9.540). Preoperative HPV16 infection was correlated with lesion residual and/or recurrence after LEEP (P<0.05). Conclusion LEEP can significantly improve the diagnosis rate of HSIL in low-grade CIN patients with high risk factors. The risk factors for lesion residual and/or recurrence after LEEP include HPV16 infection,lesion involvement of the inci-sion margin,and persistent HPV infection.