摘要:目的: 探讨联合LCT和高危型HPV检测对CIN宫颈治疗后的随访意义。 方法 :对200例LCT异常,高危型HPV阳性,阴道镜活检证实为CIN1~3的患者行LEEP治疗或宫颈冷刀锥切,治疗后进行严格随访,包括LCT和高危型HPV检测,阳性病例行组织学检查。 结果 :(1)所有病例经治疗后均无病变残留,其治愈率为100%。(2)从治疗后3个月起,CIN1组高危型HPV转阴率为100%。在随访的第3个月和6个月,CIN2~3组高危型HPV转阴率分别为7317%和9085%,显著低于CIN1组,差异有统计学意义(〖WTBX〗P ＜005)。(3)从随访12个月起,一直有2例病例持续HPV阳性,均为CIN3患者,但LCT和阴道镜检查未发现细胞学异常,继续随访。 结论 :CIN治疗后高危型HPV的转阴时间及转阴率与CIN的级别有关;高危型HPV持续阳性,但LCT和阴道镜检查无异常者可继续严格随访;LCT联合高危型HPV检测是CIN治疗后临床追踪随访的有效手段。Abstract: Objective: To investigate the Significance of LCT joint highrisk HPV testing for followup after CIN treatment. Methods : 200 cases that highrisk HPV infection were tested by realtime PCR and CIN1~3 were confirmed with LCT and colposcopy biopsy were considered. The patients were treated with LEEP treatment or cold knife conization. After treatment, all cases were strictly followed up with LCT and HPV test, and the patients with positive results were examined by histology. Results : 1) After treatment, there was no residual disease in all cases, the cure rate was 100%. 2) From 3 months after treatment, highrisk HPV negative rate was 100% in CIN1 cases. While at 3rd and 6th month after treatment, highrisk HPV negative rate in CIN2~3 cases were 7317% and 9085%, which were significantly lower than those in CIN1 cases,the difference was statistically significant. 3) From the 12th monthafter treatment, there are still two cases of sustained highrisk HPV positive but normal with LCT and colposcopy biopsy. All cases are still strictly followedup. Conclusion : After treatment, the negative rate and time of highrisk HPV concerned with the grade of the CIN; the patients with persistent positive highrisk HPV, but without abnormalities detected by LCT and colposcopy biopsy could continue to strictly follow up; LCT joint highrisk HPV detection is an effective clinical means for followup after CIN treatment.
【摘要】 目的 探讨宫颈上皮内瘤变（CIN）和宫颈鳞癌（SCC）组织中人类染色体端粒酶基因（hTERC）的表达和临床意义。 方法 收集2007年10月-2009年6月经病理学证实的116例宫颈脱落细胞标本，其中LSIL（CINⅠ）30例、HSIL（CINⅡ/Ⅲ）37例、SCC 16例、宫颈炎33例，用荧光原位杂交（FISH）方法检测脱落细胞hTERC基因。 结果 在宫颈炎、LSIL、HSIL和SCC组中hTERC基因的表达率分别是6.1%、16.7%、51.4%和93.8%，其中，HSIL、SCC组与宫颈炎组比较，hTERC基因阳性率差异有统计学意义（Plt;0.05），LSIL组与HSIL组比较、LSIL组与SCC组比较、HSIL组与SCC组比较，差异有统计学意义（Plt;0.05），且随着病变程度增加，hTERC基因表达率增加。 结论 hTERC基因在细胞学LSIL、HSIL和SCC中表达异常，且随病变程度增加阳性表达率也增加，可作为宫颈癌癌前病变进展的生物遗传学监测指标，并有望成为宫颈癌早期筛查方法之一。【Abstract】 Objective To explore the clinical significance and expression of the human telomerase gene (hTERC) in the cervical intraepithelial neoplasia (CIN) and squamous carcinoma of the cervix (SCC). Methods According to histological biopsy from October 2007 to June 2009, 116 pap smears were divided into LSIL (n=30), HSIL (n=37), SCC (n=16), and cervicitis (n=33) groups. Fluorescence in situ hybridization (FISH) was used to detect the expression of hTERC. Results Positive expression rate of hTERC was 6.1% in cervicitis group, 16.7% in LSIL group, 51.4% in HSIL group, and 93.8% in SCC group, respectively. Compared to cervicitis group, the expression of hTERC in HSIL and SCC groups was significantly higher (Plt;0.05). Among LSIL, HSIL, and SCC groups, there were significant differencec in hTERC expression between every two groups (Plt;0.05). From LSIL to SCC, the expression of hTERC increased obviously. Conclusion Abnormal expression of hTERC exists in LSIL, HSIL, and SCC patients, which significantly increases during malignant development. It may be a biogenetics monitor index of cervical precancerosis and will be a screening marker for cervical cancer.
【摘要】 目的 了解青年早期宫颈癌患者在卵巢移位术后的卵巢功能。 方法 2001年1月-2009年12月收治53例年龄26~40岁宫颈癌Ⅰb~Ⅱa期患者，其中27例在宫颈癌根治术中行卵巢移位术为观察组，26例行宫颈癌根治术切除双侧卵巢的为对照组。术后应用血清卵泡刺激素（FSH）、黄体生成激素（LH）、雌二醇（E2），B超及Kuppermann评分进行卵巢功能测定，随访1~4年。 结果 观察组术后4年内卵巢功能基本正常，对照组术后1个月卵巢功能丧失。观察组术后4年内血FSH、LH、E2及Kuppermann评分与对照组比较有显著性意义（Plt;0.05）；两组复发率比较无显著性意义（P gt;0.05）。 结论 青年早期宫颈癌患者在宫颈癌根治术中行卵巢移位术对其卵巢功能无明显影响。【Abstract】 Objective To investigate the function of ovary after ovarian transposition among young patients with early-stage cervical cancer. Methods A total of 53 young females (26-40 years old) with early stage cervical cancer (FIGO ⅠB or ⅡA) from January 2001 to December 2009. Ovarian transposition was performed at the same time of radical hysterectomy and pelvic lymphadenectomy on 27 patients who were the experimental group. Radical hysterectomy and pelvic lymphadenectomy was done without ovarian transposition on other 26 patients who were the control group. The function of ovarian was evaluated by serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), the ultrasound examination and Kuppermann score system in all patients during 1- 4 years’ follow-up. Results The patients in the control group became climacteric in one month after the operation. However, among the patients in the experimental group, their normal ovarian function was preserved within 1- 4 years’ follow-up. There was statistically significant difference between the experimental group and the control group regarding to serum E2, FSH, LH level and Kuppermann score of the patients (Plt;0.05). However, there was no statistically significant difference between the two groups regarding to the recurrence rate (Pgt;0.05). Conclusion Ovarian transposition has statistical significant effect on protection of ovarian function in young patients with early stage cervical cancer, who undergoes radical hysterectomy and pelvic lymphadenectomy.
目的 探讨贵州地区进行宫颈癌机会性筛查的价值。 方法 回顾性分析2010年11月－2011年10月贵州省人民医院妇科门诊及住院进行宫颈癌机会性筛查的1 842例患者资料，筛查方法包括液基细胞学技术、宫颈刮片、人乳头瘤病毒（HPV）分型检测、HPV第2代捕获杂交法检测、阴道镜检查，以病理确诊宫颈癌前病变及宫颈癌。 结果 贵州地区女性人群的HPV平均感染率为21.87%。共检出宫颈癌前病变39例（2.12%），宫颈癌2例（0.11%）。 结论 医院内就诊女性宫颈病变检出率高，应高度重视其机会性筛查，有助于早期干预治疗。
ObjectiveTo systematically review the correlation between Beclin1 protein expression and cervical cancer as well as its different clinical pathologic features. MethodsWe electronically searched databases including The Cochrane Library (Issue 1, 2014), PubMed, EMbase, Ovid, CNKI, VIP, CBM and WanFang Data from inception to February 2014, to collect the correlation between Beclin1 protein expression and cervical cancer as well as its different clinical pathologic features. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then meta-analysis was conducted using RevMan 5.2 software. ResultsA total of 5 case-control studies involving 637 patients were included, of which, 388 cases in the cervical cancer group, 130 cases in the cervical intraepithelial neoplasia (CIN) group, and 119 cases in the normal cervical tissue group. The results of meta-analysis showed that, a) as for Beclin1 expression, significant differences were found in cervical cancer vs. normal cervical tissues (OR=0.07, 95%CI 0.02 to 0.25, P < 0.000 1), cervical cancer vs. CIN (OR=0.37, 95%CI 0.23 to 0.59, P < 0.000 1), CIN vs. normal cervical tissues (OR=0.23, 95%CI 0.06 to 0.88, P=0.03), and cervical cancer tissues with vs. without lymph node metastasis (OR=0.29, 95%CI 0.17 to 0.49, P < 0.000 01). However, no significant difference was found in medium/low differentiation vs. well differentiation (OR=0.50, 95%CI 0.16 to 1.56, P=0.23), tumour diameter no less than vs. less than 4 cm (OR=0.72, 95%CI 0.44 to 1.18, P=0.20), myometrial invasion depth no less than vs. less than 1/2, and FIGO Ⅰ vs. Ⅱ (OR=0.70, 95%CI 0.44 to 1.10, P=0.12). ConclusionBeclin1 protein expression is notably associated to cervical cancer. Due to the limited quantity and quality of the included studies, the above conclusion still needs to be further verified by performing more high quality studies.
ObjectiveTo systematically review the correlation between mTOR protein expression and different clinical pathological features as well as the response to radiotherapy and chemotherapy of cervical cancer. MethodsWe electronically searched databases including The Cochrane Library (Issue 1, 2015), PubMed, EMbase, CNKI, CBM, VIP and WanFang Data from inception to April 2015 to collect case-control studies investigating the correlation between mTOR protein expression and different clinical pathological features as well as the response to radiotherapy and chemotherapy of cervical cancer. Two reviewers independently screened literature, extracted data and assessed the risk bias of the included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 8 case-control studies involving 591 patients were included. Among these cases, 365 cases were in the cervical cancer group, 135 cases were in the cervical intraepithelial neoplasia (CIN) group, and 91 cases were in the normal cervix tissue group. The results of meta-analysis showed that:(1) Compared with the normal cervix tissue group, mTOR protein was overexpressed in the cervical cancer group (OR=24.14, 95%CI 4.47 to 130.35, P=0.000 2) and the CIN group (OR=4.71, 95%CI 2.15 to 10.33, P=0.000 1); Compared with the CIN group, mTOR protein was overexpressed in the cervical cancer group (OR=5.12, 95%CI 2.96 to 8.86, P<0.000 01). (2) Compared with the non-lymphnode-metastasis group, mTOR protein was overexpressed in the lymph node metastasis group (OR=3.29, 95%CI 1.61 to 6.69, P=0.001); Compared with the FIGO I group, mTOR protein was overexpressed in the FIGO Ⅱ group (OR=3.00, 95%CI 1.49 to 6.04, P=0.002); Compared with the radiotherapy and chemotherapy responsive group, mTOR protein was overexpressed in the non-response group (OR=15.64, 95%CI 3.17 to 77.15, P=0.000 7). In addition, there was no significant difference between the medium/high differentiation group and low differentiation group (OR=1.70, 95%CI 0.75 to 3.81, P=0.20). ConclusionmTOR protein expression is associated with cervical cancer, and mTOR protein overexpression was associated with lymph node metastasis, higher FIGO and non-response to radiotherapy and chemotherapy. Due to the limited quantity and quality of the included studies, the above conclusion needs to be further verified by more high quality studies.
ObjectivesTo explore the efficacy of simultaneous chemoradiotherapy combined with surgery for locally advanced cervical patients and perform multivariable analysis.MethodsA total of 130 cases of patients with locally advanced cervical cancer who were admitted to the Second Affiliated Hospital of Fujian Medical University from June 2012 to December 2016 were randomly divided into case group and control group. The patients in the control group were treated with platinum-based radical concurrent chemoradiation. In the case group, patients received both treatment in the control group with the addition of extensive hysterectomy and pelvic lymph node dissection. The short-term efficacy and survival outcomes of the two groups were compared.ResultsThe present study was the final report of this randomized controlled trial. 68 patients were randomly enrolled into the case group and 50 patients into control group. The non-microscopic residual tumor (non-MRT) rates were 83.8% (57/68) and microscopic residual tumor (MRT) rates were 2.9% (2/68) in the experimental group. There was no significant difference between two groups (χ2=0.008, P=0.928) in 3-year progression-free survival rate (65.6%vs. 59.6%) and 4-year progression-free survival rate (52.5% vs. 56.3%). And there was no significant difference between two groups (χ2=0.361, P=0.548) in 3-year overall survival rate (80.3%vs. 74.6%) and 4-year overall survival rate (77.6% vs. 64.9%). Multivariable analysis showed that only tumor size and parametrial invasion were significant prognostic factors of PFS (P<0.05). And only parametrial invasion was a potential prognostic indicator affecting OS (P=0.078).ConclusionParametrial invasion is an important prognostic factor. Radical concurrent chemoradiotherapy combined with surgical treatment of locally advanced cervical cancer has not significantly improved progression-free survival and overall survival. The treatment regimen should be applied with caution and selectivity.
Objective To investigate the efficacy and safety of paracervical block combined with alfentanil in hysteroscopic day surgery under total intravenous anesthesia. Methods This study used a prospective randomized controlled study approach. A total of 60 day surgery patients requiring hysteroscopic surgery under general anesthesia admitted to Weifang People’s Hospital between October and December 2020 were randomly selected. All patients were divided into trial group and control group by completely random number table method, with 30 patients in each group. The trial group received paracervical block combined with total intravenous anesthesia with alfentanil, and the control group received total intravenous anesthesia with alfentanil. The general condition, operation time, recovery time, intraoperative propofol dosage, postoperative pain score, intraoperative motion response and postoperative nausea and vomiting incidence were compared between the two groups. Results There was no significant difference in age, body mass index and incidence of comorbidities between the two groups (P>0.05). There was no significant difference in the operation time, recovery time, pain score at 2 hours after operation, and incidence of nausea and vomiting between the two groups (P>0.05). In the control group, the dose of propofol [(34.07±12.67) vs. (28.33±9.10) mL], the pain score on awakening (1.50±0.78 vs. 0.77±0.50), and the incidence of body movement response (20.0 % vs. 0.0%) were higher than the trial group (P<0.05). Conclusion The use of paracervical block combined with alfentanil in hysteroscopic day surgery under total intravenous anesthesia can reduce the amount of propofol during the operation, reduce postoperative pain, and reduce perioperative adverse reactions, which has a good efficacy and safety.