宫颈疾病LEEP术后病理升级101例初步分析  

The analysis of upgrade pathologic diagnosis after cervical operation of LEEP （ A Report of 101 cases）

作　　者：朱华[1] 瞿文珍[1] 杨孝军[1] 郑飞云[1] 施铮铮[1] 帅茨霞[1] 

机构地区：[1]温州医学院附属第一医院妇产科,浙江温州325000

出　　处：《中国医师杂志》2009年第3期331-333,共3页Journal of Chinese Physician

基　　金：基金项目：浙江省温州市科委课题资助项目（y20060129）

摘　　要：目的探讨宫颈疾病LEEP术后病理升级的原因及其处理原则。方法对2005年9月～2008年5月因宫颈疾病在本院行LEEP术、术后病理升级者101例进行回顾性分析。结果101例中术前诊断为宫颈慢性炎者13例，术后分别诊断为CIN Ⅰ-Ⅲ；术前为CIN Ⅰ-Ⅲ者88例，术后分别诊为高级别CIN60例，原位癌10例，宫颈早期浸润癌10例，宫颈浸润癌8例（包括鳞癌6例及腺癌2例）。34例患者进行了再处理。再次术后病理与初次LEEP术后相符的10例，降级的14例，阴性的10例，无病理升级发现。切缘均阴性。2例宫颈浸润癌淋巴结转移。结论LEEP术后病理升级患者恶性比例较高，应重视宫颈疾病LEEP术后病理升级患者，根据患者年龄、生育要求、临床期别、病理类型等进行相应处理。Objective To investigate the reasons of upgrade pathologic diagnosis after cervical operation of LEEP and the principal of treatment. Methods 101 cases of clinical data with upgrade pathological diagnosis after LEEP in our hospital during September 2005 to May 2008 were analyzed retrospectively. Results 13 cases were diagnosed as cervical intraepithelial neoplasia （CIN） Ⅰ -Ⅲ while they were considered as chronic cervicitis pre-operation. 60 cases of upgrade CIN and 10 cases of in-situ cervical cancer and lO cases of early in-filtration cervical cancer and 8 cases of infiltration cervical cancer were diagnosed while they were considers as CIN Ⅰ- Ⅲ before LEEP. Among the 101 cases, 34 cases were re-treated. 10 cases diagnosis were the same pathological diagnosis as before, 14 cases diagnosis were downgrade and 10 cases were negative. There was no upgrade pathologic diagnosis. The cutting edges were negative. And lymphatic metastasis took place in 2 cases with infiltrating cervical cancer. Conclusion The malignant ratio of patients with upgrade pathology was high. We should pay attention to the patients with upgrade pathological diagnosis after LEEP. The possible treatment should be given to them according to their age, demands of breeding, clinical stages and types of pathologic stages.

关 键 词：宫颈疾病 外科学 病理学 电外科手术 副作用 

分 类 号：R737.33[医药卫生—肿瘤]