宫颈环形电切术诊治宫颈原位癌41例分析  

Analysis of loop electrosurgical excision procedure in the diagnosis and treatment for 41 cases of cervical carcinoma in situ

作　　者：陆春雪[1] 杜丽敏[1] 张淑兰[1] 李娜[1] 

机构地区：[1]中国医科大学附属盛京医院妇产科,辽宁沈阳110004

出　　处：《中国现代医学杂志》2007年第7期827-830,共4页China Journal of Modern Medicine

基　　金：辽宁省科技攻关资助项目(2003225004)

摘　　要：目的探讨宫颈环形电切术(LEEP)在宫颈原位癌(CIS)诊治中的价值。方法以经LEEP锥切后确诊为CIS的患者41例为研究对象,对LEEP术后行全子宫切除或二次锥切的患者34例,分析LEEP后残余宫颈的组织学状况;对全部患者以液基薄层细胞学检查(TCT)和阴道镜检查随访追踪。结果LEEP标本切缘干净、存在宫颈上皮内瘤变(CIN)I、存在CINII和存在CIS者分别占75.6%、9.8%、9.8%和4.9%。切缘干净组的病变残留率为0,明显低于切缘有CIN的各组(χ2=19.714,P=0.000)。LEEP锥切术后保留子宫的患者随访8～34个月均无复发。结论切缘干净的LEEP锥切对CIS疗效满意;对CIN行切除性治疗有利于避免CIS的漏诊。[ Objective] To study the value of loop electrosurgical excision procedure （LEEP） in the diagnosis and treatment for cervical carcinoma in situ （CIS）. [Methods] 41 cases diagnosed as CIS after LEEP conization were studied. 34 cases of them underwent hysterectomy or second conization and the pathology of their residual cervixes was analyzed. All the patients were followed up with liquid based thinprep cytological test （TCT） and colposcopy. [Results] On the margin of LEEP specimen, 75.6% was clear, 9.8% present cervical intraepithelial neoplasia （CIN） Ⅰ, 9.8% present CIN Ⅱ and 4.9% present CIS. The lesion remaining rate in the clean-margined group was 0, extremely lower than that in CIN-margined groups （χ^2 =19.714, P =0.000）. Following up for uterine-reserved patients after LEEP conization for 8-34 months, there was no recurrence. [Conclusions] LEEP conization with clean margin can aquire satisfied therapeutic effect. Ablative therapy for CIN is profitable for the avoiding of missed diagnosis of CIS.

关 键 词：宫颈上皮内瘤变 原位癌 环形电切术 

分 类 号：R737.33[医药卫生—肿瘤]