常用宫颈癌筛查方法对宫颈原位腺癌的筛查效果分析

目的:探究常用宫颈癌筛查方法在宫颈原位腺癌(AIS)中的筛查效果。方法:选取2012年07月至2020年04月中国医科大学附属盛京医院收治的127例AIS病例，对其临床表现、诊断途径进行回顾性分析。根据最终诊断是否合并鳞状上皮内病变，将127例患者分为单纯AIS组(n=49)和AIS+CIN组(n=78)。结果:127例患者中，82例(64.6%)无临床症状，其余病例常见的临床症状依次为合房出血(25.2%),阴道不规则流血(9.4%),阴道流液(3.9%)。127例患者中120例行HPV检测，总阳性率为95.8%(115/120),其中单纯AIS组阳性率为93.3%(42/45)。最常见的单一HPV感染类型依次为HPV16、18、45。HPV阳性且有分型结果的111例病例中，106例(95.5%)存在HPV16或(和)18感染，110例(99.1%)存在HPV16或(和)18或(和)45感染。127例患者中98例行细胞学检查，37.8%(37/98)的病例细胞学未见异常，49.0%(48/98)提示鳞状上皮异常，仅有13.3%(13/98)提示腺上皮异常。127例患者中93例完成了H...

Analysis of screening effect of common cervical cancer screening methods in cervical adenocarcinoma in situ

Objective:To explore the screening effect of common cervical cancer screening methods on cervical adenocarcinoma in situ (AIS).Methods:A total of 127 patients with AIS in our hospital were selected and their clinical manifestations and diagnostic approaches were retrospectively analyzed.According to the final diagnosis of squamous intraepithelial lesions,127 patients were divided into pure AIS group (n=49) and AIS+CIN group (n=78).Results:Of the 127 patients,82(64.6%) had no clinical symptoms,and the common clinical symptoms in the remaining cases were postcoital bleeding (25.2%,32/127),irregular vaginal bleeding (9.4%,12/127),vaginal discharge (3.9%,5/127).HPV testing was performed in 120 of 127 patients.95.8%(115/120) of AIS patients had positive results of HPV tests.93.3%(42/45) in pure AIS group had positive results of HPV tests.The most common single HPV infection types were HPV16,18 and 45.Among the 111 cases with positive HPV subtyepe results,106 cases (95.5%) had HPV16 or (and) 18 infection,and 110 cases (99.1%) had HPV16 or(and) 18 or(and) 45 infection.Cytology tests were performed in 98 of 127 patients.37.8%(37/98) of cases show normal.49.0%(48/98) of cases show squamous epithelial abnormalities and only 13.3%(13/98) show glandular epithelial abnormalities.HPV tests combined with cytology screenings were completed in 93 of 127 patients and positive results were observed in 91 patients (97.8%),including 94.1%(32/34) of patients in the pure AIS group and 100%(59/59) of patients in the AIS+CIN group (P=0.13).The screening rate of AIS by HPV tests combined with cytology screenings were not significantly different from that by HPV tests alone (P=0.13),but were significantly higher than that by cytology screening alone (P＜0.01).Cervical surface biopsies were performed in 122 of 127 patients,of whom 97 (79.5%) had AIS lesions.57 patients underwent endocervical curettage (ECC),of whom 21(36.8%) had AIS lesions.There was no significant difference in the detection rate of AIS in cases who underwent only cervical surface biopsy compared to those who underwent both ECC and cervical surface biopsy (P=0.13).Conclusion:HPV typing tests combined with cytological screening can screen AIS cases effectively.