Clinical analysis of 200 cases of cervical intraepithelial neoplasia

Abstract

Objective To investigate the diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Methods The clinical records and data of 200 patients with CIN diagnosed and treated in Shanxi Provincial People’s Hospital from January 2017 to January 2018 were retrospectively analyzed. All patients were diagnosed by three-step screening of the cervix, including thin-prep liquid-based cytology test (TCT) and/or human papilloma virus (HPV) detection, colposcopy and histopathology of the cervix. Loop electrosurgical excision procedure (LEEP) was performed according to patient’swillingness and HPV infection condition to diagnose cervix. For patients with cervical cancer diagnosed by patholgical examination, total laparoscopic extrafascial hysterectomy was performed. The TCT examination of cervix, colposcopy biopsy, operation and 1-year follow-up of all patients were observed. Results A total of 141 cases of low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) were detected by TCT of cervix among 200 CIN patients, and the diagnostic coincidence rate of TCT was 70.50%; while a total of 63 cases of CIN Ⅱ and CIN Ⅲ were detected by histopathology, and 45 cases of HSIL were detected by TCT, the diagnostic coincidence rate of TCT was 71.42%; 137 cases of CIN Ⅰ were detected by histopathology, 96 cases of LSIL were detected by TCT, and the diagnostic coincidence rate of TCT was 70.07%. A total of 163 cases of LSIL and HSIL were determined by colposcopy in 200 CIN patients, with the diagnostic accuracy of 81.50%; 63 cases of CIN Ⅱ and CIN Ⅲ were determined by histopathology, while 50 cases of HSIL were determined by colposcopy, with the diagnostic accuracy of 79.36%; 137 cases of CIN Ⅰ were determined by histopathology, and 113 cases of LSIL were determined by colposcopy, with the diagnostic accuracy of 82.48%. Among the 137 LSIL patients confirmed by histopathology, with cytological examination results showing cannot exlude high-grade squamous intraepithe lial lesion, aged over 45 years, and with lesions lasting for over 1 year, 52 patients underwent diagnostic LEEP operation. Among the 63 cases of HSIL confirmed by histopathology, 58 cases were treated by LEEP. Among the 63 HSIL patients, 5 patients with positive examination results in margin were given cytology + HPV + colposcopy every 6 months; and 4 of 5 patients were diagnosed as cervical cancer IA 1 stage by pathology, then the 4 patients were treated by total laparoscopic extrafascial hysterectomy after LEEP. Up to the end of 12-month follow-up, no CIN residue or cervical cancer recurrence was detected, but there were 8 cases of CIN recurrence. Conclusions Early diagnosis of precancerous cervical lesions and timely development of reasonable treatment are the key points to prevent and treat cervical cancer. Key words: Diagnosis; Precancerous cervical lesions; Treatment; Clinical analysis