RESUMO
Objective · To investigate the relationship between the results of thin prep cytologic test (TCT), high-risk human papillomavirus (Hr-HPV) detection and vaginalintraepithelial neoplasia (VAIN) after hysterectomy. Methods · A retrospective study was conducted of 56 patients with VAIN after hysterectomy. The analysis included TCT and Hr-HPV examination, clinical data and the relationship between Hr-HPV examinenation and histopathological examination of colposcopy. Results · Postoperative follow-up of TCT and Hr-HPV parallel pathological examination showed that 56 patients had vaginal stump lesions, including cervical factor hysterectomy accounted for 5.81% (45/775) and non cervical factor hysterectomy accounted for 0.19% (11/5933). The difference was statistically significant (P=0.000). In 56 cases of patients with vaginal stump lesions, Hr-HPV infection were 40 cases (accounting for 71.43%), uninfected patients were 16 cases (accounting for 28.57%). The Hr-HPV infection rates of cervical hysterectomy and non cervical factor hysterectomy patients were 80.00% (36/45) and 36.36% (4/11) respectively, and the difference was statistically significant (χ2= 6.248, P=0.012). TCT results showed that the incidence of squamous intraepithelial lesions were 42.22% (19/45) and 9.09% (1/11) respectively. Conclusion · The Hr-HPV infection rate and the morbidity of VAIN of the patients undergone hysterectomy due to the cervical lesionfactors is higher than those who had none cervical lesion factors. In order to identify VAIN early, patients who have the history of hysterectomy should undergo careful evaluation of cervical and vaginal circumstance before surgery and the routine examinations of TCT and Hr-HPV in the follow-up.
RESUMO
Objective:To evaluate the efficacy of loop electrosurgical excision procedure(LEEP) in the treatment of different grade of cervical intraepithelial neoplasia(CIN). Methods:898 cases with CIN treated by LEEP were retrospectively analyzed. Operation time, blood loss during the operation, changes of histopathologic results and high-rick HPV before and after the operation were studied. The diagnosis and treatment results by LEEP were evaluated. Results: The average operation time was 5.1 minutes. The average blood loss during the operation was 5.6 ml. The concordance rate of pathologic results under colposcope before operation and after LEEP was 77.73% (698/898) .96 cases had increased CIN grade after LEEP(10.69%). The HPV-DNA loading dose after operation declined significantly (P< 0.01). Conclusions: The detection rate of invasive cervical cancer by LEEP is higher than multiple punch biopsy under electronic colposcope. LEEP is an effective method for the diagnosis and treatment of CIN, and it can eliminate high-rick HPV at the same time of ablating the cervical lesion.