Clinical value of thinprep cytology test combined with colposcopy in diagnosis of cervical lesion
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Objective To investigate the clinical value of thinprep cytology test(TCT) combined with colposcopy in diagnosis of cervical lesion. Methods Retrospective analysis was conducted in 174 females with abnormal cervical smear. All the patients underwent colposcopy to screen the cervical lesions. According to the pathological results,the clinical value of TCT and colposcopy was analyzed and compared. Results In the 174 cases with abnormal cervical smear,the positive rate of atypical squamous cells(ASC) was 27. 0% (47/174). There were 92 low grade squamous intraepithelial lesion (LSIL) (52. 9%) ,33 high grade squamous intraepithelial lesion (HSIL) (19. 0%) and 2 squamous cell cancinoma (SCC) (1. 1%) . According to the diagnosis by biopsy and pathology,the positive rate of benign cervical cell(BCC) was 16. 1% (28/174) .cervical intraepithelial neoplnsia (CIN) I 42. 0% (73/174), CIN II 18.4% (32/174), CIN ffl 21. 8% (38/174) and SCC 1. 7% (3/174) . The coincidence rate of TCT and pathology was 83. 9% (146/174). Conclusions TCT and colposcopy are a practical approach for detecting cervical lesion. TCT combined with colposcopy is the optimal screening approach for cervical lesion, which can enhance the sensitivity and specificity of the diagnosis of cervical lesions.
Key words:
Thinprep cytology test; Cervical intraepithelial neoplnsia; Colposcopy; BiopsyKeywords:
Squamous intraepithelial lesion
Ascus (bryozoa)
Objective To evaluate the efficiency of cytologic examination of cervical smear combined with biopsy under colposcopy in diagnosis of cervical squamous intraepithelial lesions. Methods 250 women accepting the screening for cervical lesion by cytologic smear combined with colposcopy,results were assumed by pathological diagnosis gold standard. Results Among 250 cases,120 cases(48.0%) were diagnosed as abnormal by cytologic smear;pathologic examination shown that 3 cases with cervical squamous intraepithelial cancer;17(6.8%)with cervical intra epithe-lial neoplasia(CIN);81(32.4%) with HPV infections;149(58.6%) with acute or chronic cervical infections;The sensitivity,specificity,positive predictive value(PPV) and negative predictive value(NPV) of colposcopy in evaluation of CIN were 93.48%,89.69%,73.57% and 97.14%. Conclusion Cervical smear combined with biopsy under colposcopy examination can improve cervical cancer and precancerous lesions of early diagnosis of cervical cancer
Squamous intraepithelial lesion
Gold standard (test)
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Objective To investigate the effectiveness of thinprep cytologic test(TCT)combined with biopsy under colposcopy for diagnosis of cervical squamous intraepithelial lesions(CIN).Methods 519 suspicious patients were assigned to receive TCT combined with biopsy under colposcopy(TCT group,268 patients) or biopsy under colposcopy randomly(control group,251 patients).Pathologic examination of biopsy sample was used as gold standard.Results The coincidence on diagnosis of cervical lesions between TCT group and pathologic examination of biopsy sample was 72.0%(193/268),the coincidence on diagnosis of cervical lesions between control group and pathologic examination of biopsy sample was 50.1%(126/251),the difference was significant(χ2=388.62,P0.005).Conclusion TCT combined with biopsy under colposcopy may be a reliable method to screen and diagnose the precancerosis of cervix.
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Objective To determine the diagnosis value of liquid-based cytology( TCT) combined with colposcopy in cervical lesions screening. Methods 1 138 women received TCT,and 195 of them got colposcopy and autopsy,diagnosis results were compared with Histopathology. Results 195 out of 1138( 17. 14%) TCT examinations were cytology positive,157 cases( 13. 80%) were Atypical squamous cells( ASCUS),28 cases( 2. 46%) were low-grade squamous intraepithelial lesions( LSIL) and 10 cases( 0. 88%) were high-grade squamous intraepithelial lesions( HSIL). All positive cases and clinical highly suspicious cytology cervical lesions patients underwent colposcopy and endoscopic biopsy pathology. 139 cases( 71. 28%) had abnormal colposcopy images. And compared with histological,ASCUS( CINI66 cases,CIN Ⅱ 1 case),LSIL( CIN Ⅰ 13 cases,CIN Ⅱ 2 cases,CIN Ⅲ 6 cases, SCC1 cases); HSIL( CIN Ⅱ 3 cases,CIN Ⅲ 3 cases,SCC4 cases). Conclusion Cervical lesions screening by liquid-based cytology( TCT),with Biopsy pathology under colposcopy,Cervical lesions could be determined and prevented if cytology positive.
Ascus (bryozoa)
Histopathology
Liquid-based cytology
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Objective To investigate the diagnostic value of ThinPrep cytology(TCT) combined with colposcopy for cervical lesions.Methods 980 patients with suspected cervical lesions were selected and received TCT combined with colposcopy examination.Among the 980 patients,102 patients with positive smear were referred for colposcopy and were diagnosed by colposcopy biopsy.Results Of 102 patients with positive smear,the detection rates of the atypical squamous cells (ASC),low-grade squamous intraepithelial lesions (LSIL),cervical intraepithelial neoplasia (HSIL) and atypical glandular cells (AGC) were 6.1％,0.6％,2.1％ and 1.5％,respectively.Compared with the colposcopy biopsy for cytology samples,the test results were as follows:LSIL was 72.4％ (21/29),HSIL was 93.8％ (15/16).Conclusion The method of TCT could increase the screening rate of positive diagnosis of cervical lesions and for the highly suspected patients,the combination of vaginal colposcopy and biopsy could further improve the accuracy of diagnosis,in order to provide scientific solutions for clinical treatment.
Key words:
ThinPrep cytology; Colposcopy; Cervical lesions; Diagnostic value
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Objective To study the value of thinprep cytology test(TCT) combined with the results of cervical biopsy by colposcopy in diagnosis of cervical lesions.Methods Retrospective analysis of 11 361 cases examined with TCT and TBS diagnosis,some positive cases with TCT did cervical biopsy by colposcopy and histopathological examination.Results There were 638 positive cases of 11 361 cases,the positive ratio was 5.62%,and were mainly distributed during the age of 30 to 39.Among them,390 cases were analyzed with pathologic biopsy by colposcopy,and to be divided into the following subsets: 355 cases for atypical squamous cell(ASC,3.12%),219 cases for low-grade squamous intraepithelial lesion(LSIL,1.93%),39 cases for high-grade squamous intraepithelial lesion(HSIL,0.34%),2 cases for squamous cell carcinoma(SCC,0.02%).Compared with the positive rate and coincidence rate from the pathologic diagnosis,SCC 100%,100%;HSIL 100%,83.33%;LSIL 68.60%,62.32%.Conclusion TCT technique combined with cervical biopsy by colposcopy is a reliable means to screen and diagnose cervical cancer and precancerous lesions.
Squamous intraepithelial lesion
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Objective To investigate the TCT combined colposcopy biopsy in the diagnosis of cervical lesions in the application.Methods from November 2006 to September 2009 attendance at the Suzhou Kowloon Hospital 8 377 cases of patients undergoing outpatient gynecological TCT,in which cytology-positive patients in parallel to further colposcopy biopsy.Results The cytology-positive patients,225 cases,of which ASCUS142 cases,LSIL 41 cases,HSIL 33 cases of pathology consistent with rates of 73.9%,53.7%,51.5%.225 cases of cervical biopsy colposcopy CIN were found in more than 105 cases of cases pathology accounted for the positive rate(46.7%).CIN and carcinoma in situ of age mainly in the 20-49 years of age,CIN occurred in the 20-39 years of age accounted for 58.1%.Conclusion TCT and pathological histology have a higher line rate,the joint colposcopy biopsy can improve the detection rate of cervical lesions can be used as diagnostic methods for cervical lesions.
Outpatient clinic
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Objective:To explore the TCT colposcopy for cervical disease diagnosis.Methods:TCT on 1 280 cases of women screened,130 cases of cervical disease were detected after colposcopy and histopathology examination to histopathology as the gold standard.Results:Pathological examination colposcopy biopsy detection rate was higher than cytology.Conclusion:TCT screening combined colposcopy biopsy can significantly improve the diagnosis of cervical dis ease,the positive rate.
Histopathology
Gold standard (test)
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Objective To investigate the value and the clinical significance of cervical lesions' thinprep cell test(TCT) and colposcopy combination inspection.Methods From 2007 March to 2008 July,our hospitals' gynecology clinic accepted 1100 patients,with condition include cervical erosion,hypertrophy,polyp,satisfied capsule,irregular vaginal bleeding,leucorrhea increase etc,all of whom had been inspected by the combination of thinprep cell test(TCT) and biopsy under colposcopy.Results In TCT inspection,ASCUS 62 cases,LSIL 24 cases,HSIL 24 cases,Cancer 4 cases.In colposcopy inspection,Cervical condyloma and intraepithelial white vinegar 56 cases,Low-grade lesions 17 cases,High-grade lesions 12 cases,Cancer 4 cases.In pathological examination,CIN 54 cases,CIN 6 cases,CIN 9 cases,Cancer 3 cases.For TCT diagnosis CIN,the diagnostic accuracy is 63.2%,sensitivity 75%,specificity 93.9%;for colposcopy diagnosis CIN,the diagnostic accuracy is 83%,sensitivity 85.9%,specificity 97.3%.Conclusions The inspection combined with TCT and colposcopy pathological examination can find precancerous lesions,early cancer as early as possible,to reduce the misdiagnosis and missed diagnosis.
Ascus (bryozoa)
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Objective To evaluate digital colposcopy and TCT in the diagnosis of early cervical lesions.Methods A retrospective review was conducted on the clinical records of 379 cases,including data of cervical cytology,digital colposcopy and pathology.Results Among the 379 cases,35 cases were diagnoses as cervical intraepithelial neoplasia(CIN) and 11 cases squamous carcinoma1.The accuracies of the diagnosis were 89.18% by cytology,and 95.25% by digital colposcopy.No case was missed diagnosis by the combination of cytology and colposcopy.Conclusion Colposcopy and TCT are of high value in diagnosis of early cervical lesions.
Squamous intraepithelial lesion
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Objective:To explore the diagnosis significance of colposcopy using for biopsy in the TCT-positive patients for the cervical lesion , especially cervical intraepithelial neoplasia (CIN). Methods:Cervical Biopsy was made on 950 TCT-positive Patients for the Cervical Lesion, 670 cases accepting the examination of colposcopy was regarded as objective group, 280 cases accepting the normal biopsy examination was regarded as control group , contrasting rate of diagnosing CIN between two groups. Analysis of coincident rate of diagnosing between TCT and biopsy under colposcope in objective group. Results:Coincident rate of diagnosing CIN was 63.73% and 33.21% for objective group and control group respectively, the difference of coincident rate was statistically significant(P0.01). Coincident rate of diagnosing between TCT and biopsy under colposcope in objective group of LSIL, HSIL and SCC was 73.47%(216/294),81.95%(CINⅡ79/100、CINⅢ30/33) and 100%(3/3) respectively . Conclusion:Combination of TCT, colposcopy and cervical biopsy under colposcope could increase the diagnosis rate of CIN, especially HSIL and SCC. Which is good for early diagnosis of cervical lesion
Punch Biopsy
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