Evaluation For Cervical Disease CIN By Colposcopy Associated With Pathological Micro-vessel Density (MVD)

Section 1 MVD Evaluation in Different grades of CINObjective:To analyze MVD in different grades of CIN (CINⅠ/Ⅱ/Ⅲ) and the relationship of MVD to pathological grade.Methods:From January 2009 to August 2009,165 cases with CIN and 19 controls were recruited from Department of Cervical Disease, Ob.& Gyn. Hospital of Fudan University. In the case group, there were 18 CINⅠ,24 CINⅡand 123 CINⅢ(including 84 cases of high-grade atypical hyperplasia and 39 cases of cervical carcinoma in situ). The patients were 24 to 53 years old, and mean age was 38. All the cases were diagnosed pathologically through biopsy, and were evaluated for MVD with anti-CD31 antibody by S-P assay to show vascular endothelial cells. Assessment of MVD:According to the method of Weidner, micro vessels were calculated at 200 magnification by three different person, and the average score was taken as MVD.Results: MVD score is 34.11±3.8,25.94±4.59,33.25±4.5,39.19±2.18 in chronic cervicitis, CINⅠ, CINⅡ, and CINⅢ, respectively. There mean is statistically difference in MVD between CINⅠand CINⅢ(p<0.05), but there is no significant difference between CINⅡand CINⅢ.We have demonstrated the positive relationship of MVD to CIN by using spearman rank-related test (P<0.05), i.e., MVD increases accordingly along with higher grade of CIN.Conclusions:MVD is closely related to CIN grades.Section 2 Relationship of Vascular Morphology in Direct Vision of Colposcopy to MVD and Grades in CINObjective:To investigate the relationship of vascular morphology in direct vision of colposcopy to MVD of the biopsy tissue, and their relation to grades of CIN. Methods:The punctuation, mosaic and abnormal vessels appearances were evaluated by colposcope for 72 cases of different grades of CIN. MVD score was counted in biopsy tissue.Results:Mean MVD score in 48 punctuations is 33.8±1.6, and 42.7±2.6 in 19 mosaics,59.0±1.4 in 5 abnormal vessels, respectively. In our study, mean MVD in punctuations is significantly lower than that of mosaics (p<0.01), and even lower than that of abnormal vessels (p<0.01); but there is no significant difference between the mosaics and abnormal vessels. Either the spearman rank-related test or the linear regression shows the positive relationship of vascular morphology in direct vision of colposcopy to MVD of the biopsy tissue (P<0.05). MVD score increases accordingly with the aggravation of vascular morphology (from punctuation, mosaic, to abnormal vessels appearance).Conclusions:MVD of the abnormal vessels is the highest, and then that of mosaic, punctuation under colposcope. Cervical vascular atypia under colposcope aggravates with CIN grade increasing. Overall, the different vessel appearance under colposcope combined with MVD through pathological examination may be of positive significance in early screening, diagnosis and prognosis of the CIN.