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目的:检测的CIN不同病变程度及阴道镜下不同血管表现的微血管密度(MVD)表达,揭示该指标与宫颈CIN病理分化的关系,评估MVD及阴道镜下血管表现不同对不同病变程度CIN的诊断及判断预后的价值。方法:2009年1月~8月复旦大学妇产科医院宫颈疾病诊疗中心诊治的宫颈癌前病变(CIN)165例,其中CINⅠ18例,CINⅡ24例,CINⅢ123例。正常对照组19例。采用免疫组化SP法,分别检测各组病理标本MVD。对其中72例阴道镜下表现为点状和镶嵌状血管和异形血管的活检组织进行MVD测定。结果:CINⅠ和CINⅢ的平均MVD之间存在统计学差异(P<0.05)。CINⅡ和CINⅢ的平均MVD之间无统计学差异。CIN与MVD之间有相关性(r=0.3168,P<0.05)。点状血管表现者平均MVD显著低于镶嵌者平均MVD(P<0.01);更显著低于异形血管表现者的平均MVD(P<0.01);但镶嵌与异形血管之间MVD均无统计学差异。阴道镜下血管形态与MVD之间有相关性(r=0.4542,P<0.05)。结论:CIN病变程度及阴道镜下不同血管表现与MVD呈正相关。阴道镜下观察不同血管表现联合检测MVD可能在CIN的早期诊断、预后判断中具有一定意义。
OBJECTIVE: To detect the expression of MVD in different pathological changes of CIN and different vessels under colposcopy, and to reveal the relationship between this index and the pathological differentiation of cervical CIN. To evaluate the diagnostic value of different manifestations of MVD and colposcopy in different lesion CIN And determine the value of prognosis. Methods: From January to August 2009, 165 cases of cervical precancerous lesions (CIN) were diagnosed and treated by Department of Gynecology and Obstetrics, Fudan University Obstetrics and Gynecology Hospital. Among them, CINⅠ18 cases, CINⅡ24 cases and CINⅢ123 cases. Normal control group of 19 cases. Immunohistochemical SP method was used to detect MVD in each group. The biopsy specimens of 72 biopsies showed dot-like, mosaic-like and irregular shaped blood vessels underwent colposcopy. Results: There was a significant difference between the mean MVD of CINⅠand CINⅢ (P <0.05). There was no significant difference between the mean MVD of CINII and CINIII. There was a correlation between CIN and MVD (r = 0.3168, P <0.05). The mean MVD of punctate vessels was significantly lower than that of invaders (P <0.01), but lower than that of abnormal vessels (P <0.01), but there was no significant difference in MVD between mosaic and irregular vessels . There was a correlation between colposcopic vascular morphology and MVD (r = 0.4542, P <0.05). Conclusion: The severity of CIN and the different vascular findings under colposcopy are positively correlated with MVD. Colposcopy observation of different vascular manifestations combined with MVD may be in the early diagnosis of CIN, the prognosis of a certain significance.