山西中医药大学学报2025，Vol.26Issue(2)：185-190,6.DOI:10.19763/j.cnki.2096-7403.2025.02.10
高级别宫颈上皮内瘤变病理三维成像特征与证的相关性
Correlation between pathological three-dimensional imaging features and syndromes of high-grade cervical intraepithelial neoplasia
摘要
Abstract
Objective:To investigate the correlation between pathological three-dimensional imaging features and syn-dromes of high-grade cervical intraepithelial neoplasia(HSIL).Methods:A total of 63 patients who underwent cervical conization for the first time and were diagnosed as HSIL by postoperative pathology were selected.The information of four TCM diagnoses and colposcopy images were collected for TCM syndrome differentiation.The pathological sections of cervi-cal cone were reconstructed by pathological three-dimensional reconstruction(PTDR),and the pathological three-dimensional imaging features were obtained.Results:Among the 63 patients with HSIL,there were 17 cases of spleen vacu-ity with damp encumbrance syndrome,16 cases of accumulation of dampness and toxicity syndrome,13 cases of Yin defi-ciency combined with dampness-heat syndrome,10 cases of down-flowing of dampness and heat syndrome,and 7 cases of kidney-Yang deficiency syndrome.Among 63 HSIL patients,22 had lesions≥1 cm and 41 had lesions<1 cm.The lesions in-volved glands in 42 cases.There were 17 cases with lesions in one quadrant,23 cases with lesions in two quadrants,18 cases with lesions in three quadrants,and 5 cases with lesions in four quadrants.There were 15 cases of positive resection margin and 48 cases of negative resection margin.There were 33 cases with single lesion and 30 cases with multiple lesions.The TCM syndrome types of HSIL patients were correlated with the three-dimensional characteristics of cervical conization pathological sections.The proportion of lesions≥1 cm(10/16),lesion distribution quadrants>2(13/16)and multiple lesions(12/16)in cervical conization specimens of 16 patients with HSIL with accumulation of dampness and toxicity syndrome was relatively high.The proportions of lesions<1 cm(12/13)and single lesion(11/13)in cervical conization specimens of 13 HSIL patients with Yin deficiency combined with dampness-heat syndrome were relatively high.Among the 17 patients with HSIL of spleen vacuity with damp encumbrance,the proportion of lesion distribution quadrants≤2(15/17)was relatively high.And the differences were statistically significant(P≤0.05).There was no statistical significance in the status of glands involved and the margin of lesions in cervical conization specimens of HSIL patients with different syndromes(P>0.05).Conclusion:With the aggravation of dampness-heat,the lesions of cervical intraepithelial neoplasia show an aggravating trend,and the risk factors of residual and recurrence increase.Clinically,according to the degree of dampness-heat,hierar-chical management can be carried out,and TCM intervention can be carried out in time to promote the disappearance of dampness-heat,so as to reduce the occurrence of adverse outcomes.关键词
高级别宫颈上皮内瘤变/中医辨证/相关性/病理三维成像特征Key words
HSIL/TCM syndrome differentiation/correlation/pathological three-dimensional imaging features分类
医药卫生引用本文复制引用
黄梅芳,刘用诚,龚婷婷,林建龙,吴冬梅..高级别宫颈上皮内瘤变病理三维成像特征与证的相关性[J].山西中医药大学学报,2025,26(2):185-190,6.基金项目
第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号) （国中医药人教函[2022]1号）
福建省卫健委科技计划项目(2020CXA051) （2020CXA051）
