Ginekologinė citopatologija - gimdos kaklelio vėžio tyrimai: ŽPV ir IHC diagnostikoje, VPC rezultatai. Donatas Petroška 2014-04-10.

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Presentation transcript:

Ginekologinė citopatologija - gimdos kaklelio vėžio tyrimai: ŽPV ir IHC diagnostikoje, VPC rezultatai. Donatas Petroška 2014-04-10

Priemonės: skystų terpių citologijos metodikos Išvados: Neįtakoja kraujas, gleivės, naudoti lubrikantai. Ženkliai sumažinama netinkamų tepinėlių Tikėtina aptinkti daugiau ikivėžinių bei vėžinių pakitimų. Tyrimą galima pakartoti. Galima papildomai atlikti kitus tyrimus: ŽPV, LPI, IHC.

ŽPV tipai Genotipuojami Yra/nėra 20 14 17 2 12 18 26 15 16,18, 6,11; 16,18, 6,11; 26, 31,33,35,39,45,51, 52,53,56,58,59,66,68,73,82 (16) 16,18; 31,33,35,39,45,51, 52, 56,58,59,66,68 (12) 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, 82 16, 18, 31, 33, 35, 39, 45, 52, 56, 58, 59, 66, 68, 82 16, 18 31, 33, 35,39,45,51, 52, 53, 56,58,59,66,68, 73, 82) (15) 6, 11 16, 18, 31, 33, 35, 39, 45, 52, 56, 58, 59, 66 (12) 16 , 18 HR (11) (31, 33, 35, 45,51, 56, 58, 59, 66, 67, 70) LR(5) (6, 11, 42, 43,44) ŽPV DNR 16, 18, 26,31,33,35,39,45,51,52,53,56,58,59,66,67,68,69,73,82,6,11,30,34,70,85 16, 18, 31,33,35,39,45,51,52,56,58,59,66,68 16, 18, 31,33, 45, 35/68, 39/56, 58/52, 59/51, 6/11 20 14 17 2 12 18 26 15 16,18,31,33,35, 39, 45, 51, 52, 56, 58, 59, 66, 68

ŽPV rezultatai Tipas N (%) %* 16 54 (26%) 53% 18 7 (3.4%) 6.3% 6/11 15 (7.3%) 0.5% (6 tipas) HR 130 (63%) 7.3% (32, 33, 45, 58, 66 tipai) viso 206 (100%) *Žmogaus papilomos viruso, jo tipų ir variantų tyrimai Živilė Gudlevičienė, Janina Didžiapetrienė, Kęstutis Sužiedėlis, Laura Lapkauskaitė. Medicina (Kaunas) 2005; 41(11)

High-risk HPV was positive in 127 (42.2%) ASCUS, 129 (76.3%) LSIL, p16/Ki67 Improved abnormal pap smear triage using cervical cancer biomarkers. Killeen JL1, Dye T, Grace C, Hiraoka M. J Low Genit Tract Dis. 2014 Jan;18(1):1-7. RESULTS: High-risk HPV was positive in 127 (42.2%) ASCUS, 129 (76.3%) LSIL, 20 (69.0%) ASC-H, 15 (93.8%) HSIL. p16/Ki-67 was positive in 54 (17.9%) ASCUS, 73 (43.2%) LSIL, 19 (65.5%) ASC-H, For detection of CIN 2/3, sensitivity/specificity of hr-HPV was 89.29%/14.94% p16/Ki-67 was 96.43%/60.92%. Diagnostic accuracy was higher for p16/Ki-67 compared with hr-HPV. Compared to HPV, immunostain triage could have generated approximately $46,000 savings in the study population.

11. p16/Ki67+ ASC-US; ŽPV-

8. p16/Ki67+ LSIL; ŽPV18

9. p16/Ki67- ASC-H; ŽPV-