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[Systematic evaluation of the new screen methods of cervical intraepithelial neoplasm]
Li Jin1, Youfang Wang, Jinghe Lang
1Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
Objective:
To evaluate new cytologic screening methods of papnet cytology computer technology (CCT) and thinprep pap test (TPT) on cervical intraepithelial neoplasm (CIN).
Methods:
Three hundred and seventy four cases with abnormal cervical cytologic results received colposcopic examinations and multiple biopsies. The results of cytologic screening compared with the results of histologic-colposcopic diagnosis were analysed retrospectively.
Results:
A total of 374 cases were diagnosed by cytology, 9.1% with inflammations, 43.3% with low grade squamous intraepithelial lesion (LSIL) and 20.3% with high grade squamous intraepithelial lesion (HSIL) and 1.9% suspected with squamous cell carcinoma. However, after examination by colposcopy and multiple biopsies, the situation was different. The percentage of cases with inflammation increased to 53.5%, cervical intraepithelial neoplasm I (CIN I) decreased to 17.9%, CIN II and CIN III and cervical carcinoma in situ (CIS) elevated to 25.4% and invasive squamous cell carcinoma increased to 3.2%. Among cases with atypical squamous cell of undetermined significance (ASCUS), 52.6% (50/95) were with inflammations or negative results, 47.4% (45/95) with CIN I or even greater. Among 374 cases, 188 women were screened by CCT and 186 by TPT. When all cytological findings compared with the histologic-colposcopic results, respectively, the coincidence of TPT with histologic-colposcopic results was significantly higher than that of CCT (P < 0.01). The coincidence rate (79.7%) of screening cases with LSIL or inflammation was significantly higher than that (20.3%) of cases with HSIL or even greater (P < 0.01). But there was no difference between two methods. The incidence of human papillomaviral infection (HPV) infection at colposcopies was 34.0%. The high incidences of HPV and CIN infection were found among women from 20 to 30 years old and from 30 to 50 years old, respectively.
Conclusions:
Cases with abnormal cytologic findings should undergo colpscopic examination and multiple biopsies for further diagnosis. Only in this way, cases with CIN or HPV infection could not be misdiagnosed. Women ranged from 30 - 50 years old should receive cytologic screening or colposcopic examination regularly.
