经宫颈活检、锥切或全子宫切除术追踪CIN的病理分级转化及其临床意义  

Tracing CIN pathologic grade transformation and clinical significance in the cervix biopsy,LEEP and hysterectomy

作　　者：徐翠清[1] 何春年[1] 赵焕芬[1] 张洁[1] 孔虽英[1] 

机构地区：[1]河北省人民医院,石家庄050051

出　　处：《现代妇产科进展》2006年第12期908-910,共3页Progress in Obstetrics and Gynecology

基　　金：河北省科技攻关计划资助项目(No:05276101D-32)

摘　　要：目的:探讨CIN宫颈活检、锥切或全子宫切术后连续病例的病理分级转化及其临床意义。方法:收集2004年1月至2006年8月CIN活检、电热圈环切术(LEEP)或(和)全子宫切除(全切)术后连续病例的临床病理资料,对不同诊治手段和CIN病理分级转化进行对比分析。结果:经阴道镜活检,病理证实CIN85例,平均年龄40.7岁;再次宫颈锥形切除(锥切)诊治61例,最终采用全子宫切除术41例。锥切与全切转阴率、分级转低率、分级不变率和分级转高率分别为18.1%,21.3%,50.8%,9.8%和29.2%,12.2%,48.8%,9.8%。结论:本组活检诊断CIN与LEEP后病理分级符合率仅50.8%,与全子宫切除术后病理符合率仅48.8%,表明CIN的多点病变,术后分级变异性较大。Objective： To investigate the pathologic grade transformation and its clinical significance in the continual cases of cervical intraepithelial neoplasia （CIN）, after the cervix biopsy, the LEEP or/and the hysterectomy. Methods： Specimen of the cervix biopsy, the LEEP or/and the hysterectomy from January, 2004 to August, 2006 were collected, and the different diagnosis and treatment methods and the pathology grade transformtion were comparatively analysed. Results： Eighty-five cases of CIN were diagnosed by the cervix biopsy guided by vaginoscope. The average age was 40.7 years. Sixty-one cases were further treated with LEEP, and 41 cases were treated with hysterectomy. The frequency of negative LEEP and hysterectomy were 18.1% and 29.2% respectively. The frequency of upgrade pathlology, unchanged pathology and downgrade pathology were 21.3%, 50.8% and 9.8% in LEEP group, while 12.2%, 48.8% and 9.8% in hysterectomy group. Condusions： The pathology grade coincidence rate is only 50.8%, between the CLSOI and the LEEP; pathology grade coincidence rate is only 48.8%, comparing the CLSOI and the hysterectomy, which explained CIN is the multi-spots pathological changes and grade variability is quite notable.

关 键 词：百颈上皮内瘤变 电热圈环切术 病理学 临床 

分 类 号：R737.33[医药卫生—肿瘤]