Characteristics of invisible cervical intraepithelial neoplasia Ⅲ under colposcopy
10.3760/cma.j.issn.0529-567x.2018.03.006
- VernacularTitle:阴道镜下隐匿子宫颈上皮内瘤变Ⅲ级病变的HPV亚型感染特征及鳞状上皮厚度分析
- Author:
Qing CHEN
1
;
Hui DU
;
Chun WANG
;
Jinlong TANG
;
Ruifang WU
Author Information
1. 518036,北京大学深圳医院妇产科暨深圳市女性重大疾病早期诊断技术重点实验室
- Keywords:
Cervical intraepithelial neoplasia;
Squamous intraepithelial lesions of the cervix;
Colposcopy;
Papillomaviridae
- From:
Chinese Journal of Obstetrics and Gynecology
2018;53(3):172-177
- CountryChina
- Language:Chinese
-
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.
