子宫颈上皮内瘤样病变

子宫颈上皮内瘤样病变的相关文献在2001年到2020年内共计61篇,主要集中在肿瘤学、妇产科学、临床医学 等领域,其中期刊论文60篇、会议论文1篇、专利文献215008篇;相关期刊51种,包括中国妇幼健康研究、中国计划生育学杂志、中国社区医师等; 相关会议1种,包括2013全国中西医结合生殖系统炎症性疾病专题学术会议等;子宫颈上皮内瘤样病变的相关文献由173位作者贡献,包括张娟娟、陈永平、乔友林等。

子宫颈上皮内瘤样病变—发文量

期刊论文>

论文:60 占比:0.03%

会议论文>

论文:1 占比:0.00%

专利文献>

论文:215008 占比:99.97%

总计:215069篇

子宫颈上皮内瘤样病变—发文趋势图

子宫颈上皮内瘤样病变

-研究学者

  • 张娟娟
  • 陈永平
  • 乔友林
  • 刘植华
  • 刘毓林
  • 吴瑞芳
  • 吴秀霞
  • 周庆芝
  • 李瑞珍
  • 李霓
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 鲍春玉; 申艳; 顾芸
    • 摘要: 目的探讨子宫颈上皮内瘤样病变(CIN)宫颈环形电切(LEEP)术后切缘阳性的相关因素及临床处理。方法回顾性分析2016年5月至2018年5月南京市妇幼保健院收治的73例因CIN病变行LEEP术切缘阳性患者,93例切缘阴性患者,对两组患者的年龄、术前宫颈脱落细胞学检查(TCT)、人类乳头瘤病毒(HPV)感染型别、活检病变级别、病变累及颈管及腺体情况、阴道镜特点与子宫颈LEEP术切缘阳性作单因素和多因素分析,并分析不同临床处理的结局。结果患者年龄>40岁、病变累及颈管、累及腺体以及不充分阴道镜检查与切缘阳性有相关性,LEEP术切缘阳性与患者术前TCT、HPV感染型别、活检病变级别无相关性。多因素Logistic分析显示:病变累及颈管、累及腺体以及不充分阴道镜检查是切缘阳性的高度相关因素,相对危险度:7.198、2.388、16.878。切缘阳性患者二次手术病理病灶残留率21/31(67.74%),随访好转率26/33(78.79%)。结论LEEP术后标本切缘阳性主要与年龄>40岁、病变累及腺体及颈管以及不充分阴道镜检查有关。对于切缘阳性患者,应采取个体化治疗。
    • 鲍春玉; 申艳; 顾芸
    • 摘要: 目的 探讨子宫颈上皮内瘤样病变(CIN)宫颈环形电切( LEEP)术后切缘阳性的相关因素及临床处理.方法 回顾性分析2016年5月至2018年5月南京市妇幼保健院收治的73例因CIN病变行LEEP术切缘阳性患者,93例切缘阴性患者,对两组患者的年龄、术前宫颈脱落细胞学检查(TCT)、人类乳头瘤病毒(HPV)感染型别、活检病变级别、病变累及颈管及腺体情况、阴道镜特点与子宫颈LEEP术切缘阳性作单因素和多因素分析,并分析不同临床处理的结局.结果 患者年龄>40岁、病变累及颈管、累及腺体以及不充分阴道镜检查与切缘阳性有相关性,LEEP术切缘阳性与患者术前TCT、HPV感染型别、活检病变级别无相关性.多因素Logistic分析显示:病变累及颈管、累及腺体以及不充分阴道镜检查是切缘阳性的高度相关因素,相对危险度:7.198、2.388、16.878.切缘阳性患者二次手术病理病灶残留率21/31(67.74%),随访好转率26/33(78.79%).结论 LEEP术后标本切缘阳性主要与年龄>40岁、病变累及腺体及颈管以及不充分阴道镜检查有关.对于切缘阳性患者,应采取个体化治疗.
    • 陈建翠; 郑锦文; 薛慧丰; 戴丽玉; 陈巧云
    • 摘要: 目的 探讨宫颈管诊刮(ECC)对宫颈病变的诊断价值.方法 分析2017年1—10月因宫颈癌筛查结果 异常行阴道镜检查及宫颈活检同时行宫颈管诊刮的992例患者的组织病理学结果.结果 HSIL、ASC-H两组阳性率均高于LSIL、ASC-US、NILM三组,差异有统计学意义(P0.05).ECC比宫颈活检检出更高级别病变53例中,3型转化区占86.8%(46/53).结论 ECC能够提高检出宫颈病变的阳性率,建议对宫颈细胞学HSIL、ASC-H,或阴道镜下3型转化区时宫颈活检联合ECC以增加宫颈病变的检出,减少漏诊.
    • 敬源; 尹盼月
    • 摘要: Objectives:To assess the clinical significance of using direct colposcopic vision (DCV) during excision therapy of cervical intraepithelial neoplasia (CIN).Methods:The clinical and pathological data of 254 endometrial carcinoma patients hospitalized from February 2011 to July 2015 were analyzed retrospectively.Results:DCV used in excision of CIN procedure resulted in a significant reduction in the mean height and diameter of the excised specimen.The median of patients' follow-up was (29.2 ± 3.1) months.39 patients were diagnosed with treatment failure.Compared to excisions performed without colposcopy,DCV was not found to have any significant impact on the risk of treatment failure (HR:0.49;95% CI 0.21 ~2.33,P =0.468),neither when compared to excisions performed immediately after colposcopy (HR:0.92;95% CI0.57 ~ 1.68,P =0.846).The factors found to have a significant impact on the risk of treatment failure were the identification of clear margins (HR:0.35;95% CI 0.20 ~ 0.73,P =0.003) and the diameter of the surgical specimen (HR:2.56;95% CI 0.98 ~ 5.89,P =0.068).Conclusion:The use of DCV during excision therapy of CIN is associated with a significant reduction in the dimensions of the excised cervical specimen,but does not result in a significant change in the risk of treatment failure.%目的:本文研究了在子宫颈上皮内瘤样病变切除手术中应用阴道镜直视检查对患者治疗的临床意义.方法:对我院2009年2月至2010年7月期间进行切除治疗的254例子宫颈上皮内瘤样病变患者的临床资料进行了回顾性分析.结果:在子宫颈上皮内瘤样病变切除手术中应用阴道镜直视能够显著降低切除样本的平均高度和直径.患者平均随访时间为(29.2±3.1)月.39例患者最终确认为治疗无效.采用阴道镜直视切除手术的患者相对于手术中不采用阴道镜的患者,其治疗失败风险并无显著差异(HR:0.49;95%CI0.21 ~2.33,P=0.468),而相对于阴道镜检查后立即进行切除手术的患者也无显著差异(HR:0.92;95%CI0.57~1.68,P=0.846).对治疗失败风险有显著影响的因素是清晰边界的确定(HR:0.35;95% CI0.20 ~0.73,P=0.003)和手术切除直径(HR:2.56;95%CI0.98 ~5.89,P=0.068).结论:应用阴道镜直视于子宫颈上皮内瘤样病变切除手术中能够显著降低切除样本的尺寸,但不会导致治疗失败风险的显著变化.
    • 王丽凤; 韩蓉晖; 李丽; 刘玲玲; 吴翠玲; 胡丽娜; 张振华
    • 摘要: Objective To investigate p16INK4α protein expression in cervical squamous epithelium infected by high-risk HPV, and to explore the role and significance of p16INK4α in carcinogenesis. Methods High-risk HPV DNA were detected by HC2 methods. 31 cases of chronic cervicitis, 48 cases of cervical intraepithelial neoplasia (CIN) (including 16 cases of CINⅠ, 14 cases of CINⅡ, 18 cases of CINⅢ) and 48 cases squamous cell carcinoma (SCC) cervical tissues with high-risk HPV-positive were collected. p16INK4αprotein was detected by immunohistochemistry. Results The positive rates of p16INK4α were 0 (0/31), 25 %(4/16), 100 % (14/14), 100 % (18/18) and 100 % (48/48) in chronic cervicitis, CINⅠ, CINⅡ, CINⅢ and SCC group, respectively. The positive rates of CINⅡ , CINⅢ and SCC groups were significantly higher than those of chronic cervicitis and CINⅠ groups (P<0.05). Conclusion The positive expression of p16INK4αprotein indicates cervical squamous epithelium dysplasia, which is the important reference in accurate diagnosis of cervical squamous intraepithelial lesions infected by high-risk HPV.%目的:研究高危型人乳头瘤病毒(HPV)感染的子宫颈鳞状上皮组织中p16INK4α蛋白表达情况,探讨其在子宫颈鳞状上皮癌变过程中的作用。方法应用HC2法检测子宫颈高危型HPV-DNA,收集HPV阳性的慢性子宫颈炎组织31例、子宫颈上皮内瘤变(CIN)组织48例(CINⅠ级16例、CINⅡ级14例、CINⅢ级18例)及鳞状细胞癌组织48例,采用免疫组织化学法检测各组p16INK4α蛋白表达情况。结果慢性子宫颈炎组、CINⅠ级组、CINⅡ级组、CINⅢ级组及鳞状细胞癌组中p16INK4α蛋白阳性率分别为0(0/31)、25%(4/16)、100%(14/14)、100%(18/18)及100%(48/48)。 CINⅡ级及以上病变组中p16INK4α蛋白阳性率明显高于慢性子宫颈炎组及CINⅠ级组(P<0.05)。结论 p16INK4α蛋白阳性表达可反映鳞状上皮异型增生,对高危型HPV感染的子宫颈鳞状上皮内病变的准确诊断具有重要参考价值。
    • 周洪园; 邹燕丽; 卓俊菊; 彭泊芳; 李红
    • 摘要: Objective To investigate the clinical application value of stathmin, p16 and Ki-67 in the cervical intractable cases. Methods Immunohistochemical method was used to detect the expressions of stathmin, p16 and Ki-67 in surgical specimens of 288 cervical intractable cases, including 30 cases of cervical benign changes, 70 cases of cervical intraepithelial neoplasia (CIN)Ⅰ, 78 cases of CINⅡ, 85 cases of CINⅢand 25 cases of squamous cell carcinoma (SCC, as control group). The application value of stathmin, p16 and Ki-67 in the cervical cases were analyzed. Results The positive expression rates of Ki-67 of cervical benign changes and CINⅠwere 20.0 % (6/30) and 54.3 % (38/70) (χ2 = 3.29, P> 0.05). The expression rates of Ki-67 in CINⅡ, CINⅢ and SCC were all 100.0 %, and compared with the cervix benign changes, the differences were statistically significant (χ2= 112, P0.05), but the expression rates in CINⅢ and SCC were higher than those in cervical benign change, CINⅠand CIN Ⅱ(P< 0.01). The positive expressions of stathmin, p16 and Ki-67 in each group of CIN were positively correlated (r= 0.412, P< 0.05). Conclusions Combined detection of p16 and Ki-67 can assist in the differential diagnosis of cervical intractable cases, and provide objective indicators for the classification and accurate diagnosis of CIN. Combined detection of p16 and stathmin may help to identify high-grade, low-grade CIN and cervix benign changes for the reduction of over-treatment.%目的:探讨stathmin、p16、Ki-67检测在子宫颈疑难病例中的应用价值。方法应用免疫组织化学标志物检测288例子宫颈疑难病例标本中子宫颈良性反应性改变(30例)、子宫颈上皮内瘤变(CIN)Ⅰ级(70例)、CINⅡ级(78例)、CINⅢ级(85例)及子宫颈鳞状细胞癌(25例,对照组)中stathmin、p16、Ki-67的表达情况,并分析三者在子宫颈疑难病例中的检测价值。结果 Ki-67在子宫颈良性反应性改变和CINⅠ级中的阳性表达率为20.0%(6/30)和54.3%(38/70),差异无统计学意义(χ2=3.29,P>0.05);在CINⅡ级、CINⅢ级和子宫颈癌对照组中的阳性表达率均为100.0%,与子宫颈良性反应性改变比较,差异有统计学意义(χ2=112,P<0.05)。 p16在子宫颈良性反应性改变和CINⅠ级中的阳性表达率为6.7%(2/30)和91.4%(64/70),差异有统计学意义(χ2=50.64,P<0.05);在CINⅡ级、CINⅢ级和子宫颈癌对照组中的阳性表达率均为100.0%,与子宫颈良性反应性改变比较,差异有统计学意义(χ2=7.18,P<0.01)。 stathmin在子宫颈良性反应性改变、CINⅠ级、CINⅡ级、CINⅢ级和子宫颈癌对照组中的阳性表达率分别为3.3%(1/30)、5.7%(4/70)、23.0%(18/78)、78.9%(67/87)和100.0%(25/25),其中子宫颈良性反应性改变、CINⅠ级和CINⅡ级间的表达差异无统计学意义(χ2=0.68,P>0.05);CINⅢ级与子宫颈癌对照组中的表达较子宫颈良性反应性改变、CINⅠ级、CINⅡ级增高,差异有统计学意义(P<0.01)。 stathmin、p16与Ki-67的阳性表达强度与CIN分级呈正相关(r=0.412,P<0.05)。结论联合检测p16及Ki-67能够辅助鉴别诊断子宫颈疑难病例,为CIN的分级和精确诊断提供客观依据。联合检测p16及stathmin有助于鉴别高级别、低级别CIN和良性反应性改变,减少过度治疗。
    • 徐多; 何莲芝
    • 摘要: 目的:评估HPV E6/E7 mRNA在宫颈病变诊断中的价值.方法:选取弋矶山医院2014年9月~2015年9月HPVDNA阳性且TCT检测为慢性宫颈炎患者197例,行HPV E6/E7 mRNA及阴道镜下宫颈组织病理学检测.结果:197例HPV阳性患者中,HPV E6/E7 mRNA的阳性率为62.44%,敏感度为91.18%,特异度为52.17%,阳性预测值为50.14%,阴性预测值为91.89%.不同组织学分级中,HPV E6/E7 mRNA的阳性表达率在宫颈炎组与CIN Ⅰ组、宫颈炎组与Ⅱ组、宫颈炎组与Ⅲ组均具有统计学差异(P<0.01).HPV E6/E7 mRNA检测与病理学诊断符合率为90%.结论:HPV E6/E7mRNA的表达与宫颈病变密切相关,可用于评估宫颈癌的发病风险.在早期或低级别病变中,HPV E6/E7 mRNA检测对预测高级别宫颈上皮内瘤变的发生有着重要作用.
    • 孙小云; 张旭艳; 闫雪; 路中; 陈昭日
    • 摘要: 目的:探讨高迁移率族蛋白1(HMGB 1)及人跨膜蛋白 Notch1在宫颈癌发病中的作用及相关性。方法选择子宫颈组织标本54例份,包括子宫颈鳞癌18例份(宫颈癌组)、子宫颈上皮内瘤变18例份( CIN组)、正常子宫颈组织18例份(对照组),采用Western blot方法检测各组HMGB 1、Notch1蛋白的表达情况,采用线性相关分析法分析HMGB 1、Notch1蛋白在CIN及宫颈癌组织中的相关性。结果宫颈癌组HMGB1蛋白表达高于CIN组及对照组,CIN组HMGB1蛋白表达高于对照组(P均<0.05)。宫颈癌组Notch1蛋白表达高于CIN组及对照组,CIN组Notch1蛋白表达高于对照组(P均<0.05)。 CIN组HMGB1与Notch1蛋白表达呈正相关(r=0.96,P<0.05),宫颈癌组HMGB1与 Notch1蛋白表达呈正相关(r=0.96,P<0.05)。结论HMGB1、Notch1蛋白在CIN及宫颈癌组织中均表达增高,两者在CIN及宫颈癌组织中的表达呈正相关,可能共同参与宫颈癌的发病。
    • 陈新妹; 王楚华; 刘露晖; 王栾玲; 肖杏葵; 郭晓琴
    • 摘要: 目的:观察 Cervista 高危型人乳头瘤病毒(HR-HPV)检测技术及 HR-HPV 分型对宫颈癌筛查的有效性及临床价值。方法对1000名妇女同时行液基细胞学(TCT)及 Cervista 技术检测 HR-HPV,对细胞学检测大于或等于 ASC-US 的患者行病理活组织检查(活检)。评价细胞学级别、病理学级别,记录不同 TCT 级别及不同病理学级别的 HR-HPV 分型(A9、A7、A5/A6),分析 HR-HPV 分型与 CINⅢ级或以上级别的关系。结果ASC-US 及以上级别者的 HR-HPV 阳性率均高于正常或炎症级别者,LSIL 及 HSIL 级别者的 HR-HPV 阳性率均高于 ASC-US 级别者,HSIL 级别者的 HR-HPV 阳性率高于 ASC-H 级别者,P 均<0.005。LSIL 及 HSIL 级别者 A9型阳性率高于正常或炎症级别者,HSIL 级别者 A9型阳性率高于 ASC-US 者,P 均<0.005。对细胞学结果为 ASC-US 及以上的246例患者进行活检,HR-HPV 的阳性率从炎症时的40.9%逐渐升高到 CINⅢ级别时的92.9%。CINⅡ、CINⅢ者 A9型 HR-HPV 感染阳性率均高于炎症及 CINⅠ者(P 均<0.005)。针对 CINⅢ或以上级别病变,HR-HPV 的敏感度为93.3%、特异度为48.8%,阳性预测值6.7%,阴性预测值99.0%,约登指数0.42。各 HR-HPV 分型中,HR-HPV A9的敏感度及约登指数较高。结论Cervista HR-HPV 对 CINⅢ或以上病变检测的敏感度、阴性预测值较高,可用于宫颈癌的筛查。当患者检出 A9型 HR-HPV 感染时,需建议患者进一步检查或加强随访。%Objective To observe the validity and clinical value of the Cervista high-risk human pap-illomaviral infection (HR-HPV)testing and HPV genotyping in the screening of cervical cancer.Methods A total of 1 000 women simultaneously received liquid-based cytology (TCT)and Cervista technology for detection of HR-HPV.Patitents suspected with cytological characteristics of atypicai squamous cells of unknown signifi-cance (ASC-US)grade or above underwent histopathological biopsy.Cytological and pathological grades were evaluated.HR-HPV genotypes (A9,A7 and A5 /A6)of different TCT and pathological grades were recorded.The relationship between HR-HPV genotype and CINⅢ grade or above was analyzed.Results The positive rate of HR-HPV in subjects with ASCUS grade or above was significantly higher compared with those of normal and inflammatory counterparts.Compared with ASC-US subjects,those with LSIL and HSIL grade had a signif-icantly higher positive rate of HR-HPV.The positive rate of HR-HPV in those with HSIL grade was considera-bly higher than that of the subjects with ASC-H grade (all P <0.005).The positive rate of type A9 HPV in-fection in the subjects with LSIL and HSIL grade was significantly higher than that in normal and inflammation counterparts.The positive rate of type A9 HPV infection in the HSIL subjects was apparently higher than that in the ASC-US counterparts (both P <0.005).Cytological testing revealed that 246 subjects developed ASC-US grade or above and subsequently received pathological biopsy.The positive rate of HR-HPV was gradually increased from 40.9% during the inflammation stage to 92.9% in the CINⅢ stage.The subjects with CINⅡand CINⅢ grade had significantly higher positive rates of type A9 HR-HPV compared with their counterparts with inflammation and CIN I (all P <0.005).For CINⅢ grade or above,the sensitivity,specificity,positive and negative predictive values of Cervista HR-HPV were 93.8%,48.8%,6.7% and 99.0%,respectively.Youden's index was 0.42.Among different HR-HPV genotypes,the sensitivity and Youden's index of A9 type HR-HPV were the highest.Conclusion Cervista HR-HPV has a high sensitivity and negative predictive value in the screening of CIN III grade or above HR-HPV,which can be applied in the screening of cervical cancer.If detected with type A9 HR-HPV infection,the patients should receive further examination and should be closely followed up.
    • 赵爱华; 张红华
    • 摘要: 目的 观察即诊即治法(see and treat)与三阶梯法(即细胞学-阴道镜-组织学)治疗宫颈上皮内瘤样病变(CIN)的临床疗效,通过两组对比,评价两种治疗方法的优势与不足.方法 对2010年1月至2011年1月佛山市妇幼保健院和同济医院因宫颈病变行LEEP治疗的629例患者的细胞学、阴道镜、阴道镜引导宫颈活检(CDB)及宫颈电圈切除术(LEEP)组织病理学诊断结果进行回顾性分析.结果 三阶梯法(阴道镜引导宫颈活检)准确性较高,为84.57%,但存在着不足之处,即CDB诊断为低级别宫颈病变者,经LEEP治疗,术后病理证实有部分患者存在高度鳞状上皮内瘤变(HSIL).选择HSIL患者采用即诊即治法行LEEP治疗,过度治疗率达16.43%.经TCT诊断为HSIL的患者联合阴道镜检查及Reid评分,在RCI高评分组中无过度治疗.结论 CDB可以发现大部分宫颈病变的患者,不足之处是不能排除宫颈浸润癌.即诊即治法应用于TCT联合阴道镜同时诊断为HSIL的治疗方法值得推广,可弥补CDB的不足,最大限度地提高宫颈病变诊断及治疗的及时性和准确性.%Objective To observe and compare the effiacies of "see and treat" and three step strategy (cytology,colposcopy,and histology)for cervical intraepithelial neoplasia (CIN) and then to evaluate the advantages and disadvantages of the two methods.Methods The histopathological results of cytology,colposcopy,colposcopically directed biopsy(CDB),and LEEP in 629 patients with CIN treated by LEEP at Tongji Hospital and Maternity and Children's health Care Center of Foshan from January,2010 to January,2011 were retrospectively analyzed.Results The accuracy of CDB was 84.57%.CDB had some drawbacks that some patients be diagnosed with low grade CIN by CDB but with highly squamous intraepithelial neoplasia (HSIL) by postoperative pathology.Some patients with HSIL were chosen and treated by LEEP through "see and treat" method,and 16.43% patients were over-treated.The patients with HSIL confirmed by TCT,coupled with colposcopy and Reid score,weren' t over-treated in high RCI score group.Conclusions Most CIN can be found out buting cervical invasive carcinoma can't ruled out by CDB."See and treat" for HSIL confirmed by TCT and colposcope is worth being clinically generalized,can make up for the inadequacy of CDB,maximumly improve the timeliness and diagnosis of CIN.
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