Yang Shu-li, Kong Wei-min, Wu Yu-mei, Duan Wei, Zhu Li
Department of Gynecologic Oncology, Capital Medical University, Beijing, China.
Zhonghua Fu Chan Ke Za Zhi. 2013 May;48(5):344-7.
To investigate diagnostic approaches of cervical glandular intraepithelial neoplasia (CGIN) for improving the diagnostic levels of CGIN.
Clinical data of 106 cases with CGIN admitted in hospital from Jan.2008 to Dec. 2010 were analyzed retrospectively.All data from preoperative thin-prep cytologic test (TCT), cervical biopsies and postoperative pathological examination of the excised cervical tissues were reviewed.
Among 106 patients, 62 cases (58.5%, 62/106) were low grade CGIN (L-CGIN), 44 cases (41.5%, 44/106) were high grade CGIN (H-CGIN); 25 cases (23.6%, 25/106) were pure CGIN and 81 cases (76.4%, 81/106) were CGIN mixed with cervical intraepithelial neoplasia (CIN). Fifteen cases (14.2%, 15/106) were found atypical glandular cell (AGC) by TCT. In the 15 cases, there were 4 cases (6.5%, 4/62) L-CGIN, and 11 cases (25.0%, 11/44) H-CGIN, there was significant difference between the two groups (P < 0.05); among 15 cases with AGC, 11 cases of them (44.0%, 11/25) were pure CGIN, 4 cases (4.9%, 4/81) mixed with CIN, in which there were significant difference (P < 0.01).Seven cases (25.0%, 7/28) were detected glandular lesions in 28 cases by endocervical curettage (ECC). Totally 23 cases (22.8%, 23/101) were detected CGIN by colposcopy-directed biopsy, 11 cases (19.0%, 11/58) were with L-CGIN, 12 cases (27.9%, 12/43) H-CGIN, there was no significant difference between them (P > 0.05).Among the 23 cases, 13 cases (52.0%, 13/25) were pure CGIN, 10 cases (12.3%, 10/81) CGIN mixed with CIN, which showed significant difference (P < 0.01). All 106 patients were treated, 101 cases treated with cervical conization and 5 cases performed hysterectomy; 23 cases were diagnosed CGIN preoperation, the ratio of preoperative diagnosis was 21.7% (23/106), 83 cases (80.3%, 83/106) diagnosed postoperatively.
Routine diagnostic methods of CGIN were not satisfaction, most CGIN were diagnosed after cervical resection.Cervical conization may play a very important role in diagnosis of CGIN.The positivity of TCT in H-CGIN was higher than L-CGIN. There was no different in diagnosing different CGIN grades by colposcopy-directed biopsy. The ratio of preoperative diagnosis of pure CGIN was higher than those with CGIN mixed with CIN.
探讨宫颈腺上皮内瘤变（CGIN）的诊断方法，以提高CGIN的诊断水平。
回顾性分析2008年1月至2010年12月收治的106例CGIN患者的临床资料。复习术前薄层液基细胞学检测（TCT）、宫颈活检及术后切除宫颈组织病理检查的所有数据。
106例患者中，低级别CGIN（L-CGIN）62例（58.5%，62/106），高级别CGIN（H-CGIN）44例（41.5%，44/106）；单纯CGIN 25例（23.6%，25/106），CGIN合并宫颈上皮内瘤变（CIN）81例（76.4%，81/106）。TCT检查发现非典型腺细胞（AGC）15例（14.2%，15/106）。15例中，L-CGIN 4例（6.5%，4/62），H-CGIN 11例（25.0%，11/44），两组差异有统计学意义（P<0.05）；15例AGC患者中，单纯CGIN 11例（44.0%，11/25），合并CIN 4例（4.9%，4/81），差异有统计学意义（P<0.01）。宫颈管搔刮术（ECC）检查28例，发现腺性病变7例（25.0%，7/28）。阴道镜下活检确诊CGIN 23例（22.8%，23/101），L-CGIN 11例（19.0%，11/58），H-CGIN 12例（27.9%，12/43），差异无统计学意义（P>0.05）。23例中，单纯CGIN 13例（52.0%，13/25），合并CIN 10例（12.3% , 10/81），差异有统计学意义（P<0.01）。106例患者均接受治疗，101例行宫颈锥切术，5例行子宫切除术；术前确诊CGIN患者23例，术前诊断率为21.7%（23/106），术后确诊83例（80.3%，83/106）。
CGIN的常规诊断方法不尽人意，多数CGIN在宫颈切除术后确诊。宫颈锥切术在CGIN诊断中可能起重要作用。H-CGIN的TCT阳性率高于L-CGIN。阴道镜下活检诊断不同级别CGIN无差异。单纯CGIN的术前诊断率高于合并CIN的CGIN。
