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Characteristics of invisible cervical intraepithelial neoplasia Ⅲ under colposcopy / 中华妇产科杂志
Chinese Journal of Obstetrics and Gynecology ; (12): 172-177, 2018.
Article in Chinese | WPRIM | ID: wpr-707783
ABSTRACT
Objective To explore the human papilomavirus(HPV)genotypes and epithelial thickness of invisible cervical intraepithelial neoplasia Ⅲ(CIN Ⅲ)under colposcopy. Methods One hundred and sixty-nine biopsies from 93 patients with a final diagnosis of CIN Ⅲwere extracted from the Shenzhen cervical cancer screening trialⅡ(SHENCCASTⅡ).The SHENCCASTⅡwas conducted from 2009 to 2010.All the cervical blocks from these patients were re-cut and placed on 6 slides,i.e.sandwich model, with the top and bottom sections being stained with HE, the top second be processed for other studies, 3 sections for HPV genotypes by matrix-assisted laser desorption ionization-time of flight-mass spectrometry(MALDI-TOF-MS)assay.The thickness of squamous epithelium of CINⅢwas measured by a microscope(×10)after re-cut. Colposcope directed CIN Ⅲ biopsies positively was defined as visible CIN Ⅲ, while random CIN Ⅲ biopsies positively was defined as invisible CIN Ⅲ. Results HPV16 positivity was 37.2%(16/43)and 55.6%(70/126)between invisible and visible CIN Ⅲ biopsies, respectively(χ2=4.318,P=0.038).Forty-nine cases of the 93 CINⅢpatients were HPV16 positive,while 44 of them non-HPV16 positive. The proportion of patients with ≥45 years of age for other non-HPV16 positive 40.9%(18/44)was significantly higher than that HPV16 positive 20.4%(10/49; χ2=4.630, P=0.031).Patients with HPV16 positive were more likely to have lesions ≥1 quadrant(χ2=7.786,P=0.005) than other non-HPV16 positive. Compared the average epithelium thickness of invisible CIN Ⅲ tissue (140±12)μm,the average epithelium thickness of visible CIN Ⅲtissue(161±9)μm was thicker.There was statistical difference between two groups(t=4.383,P=0.038).The mean average epithelial thickness of CIN Ⅲwith HPV16 positive(172±11)μm was thicker than that the mean average epithelial thickness of CIN Ⅲ with non-HPV16 positive(130±10)μm(t=4.784,P=0.031). Conclusions Invisible lesions is difficult to identify under colposcopy and is related to non-HPV16 positive, small lesion size and thinner squamous epithelium. For non-HPV16 positive or older women should be performed colposcope directed biopsies and randomly multi-sites biopsies by colopscopy,which may be helpful to improve the detection of CINⅢand to reduce miss diagnosis.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Obstetrics and Gynecology Year: 2018 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Prognostic study Language: Chinese Journal: Chinese Journal of Obstetrics and Gynecology Year: 2018 Type: Article