随访宫颈电圈环切术在子宫颈上皮内瘤变诊治中的价值  

Clinical value of loop electrosurgical excision procedure in diagnosis and treatment of cervical intraepithelial neoplasia:a follow-up

作　　者：徐军[1] 王红琳[1] 陆杲川[1] 林晓[1] 周红卫[1] 

机构地区：[1]上海市第八人民医院妇产科,200233

出　　处：《上海医学》2009年第10期903-905,共3页Shanghai Medical Journal

基　　金：上海市卫生局科研项目资助(2006122)

摘　　要：目的随访高频电刀子宫颈电圈环切术(LEEP)诊断和治疗子宫颈上皮内瘤变(CIN)的临床效果。方法对阴道镜下活组织检查诊断为CIN并自愿行LEEP治疗的139例患者进行术后3、6个月及1、2年的随访,分析比较薄层液基细胞学检查(TCT)、阴道镜下活组织检查及LEEP术后病理诊断的符合率;观察LEEP术后病变持续存在率和复发率。结果阴道镜下活组织检查与LEEP术后病理诊断的符合率为85.6%;2年内随访LEEP术后的总治愈率为95.7%;术后3个月时的治愈率为98.6%,病变持续存在率为1.4%;术后6个月时的病变持续存在率和复发率均为0;术后1年和2年的复发率分别为2.9%和0。在2年的随访中,CINⅠ和CINⅡ～Ⅲ的总治愈率分别为99.0%、88.1%,病变持续存在率分别为1.0%、2.4%,复发率分别为0、9.5%。复发的患者中,3例为人乳头状病毒(HPV)16型感染,2例为HPV16和HPV18型感染,1例为HPV53型感染。结论LEEP是诊断CIN和子宫颈原位癌的可靠方法,同时也是安全、有效的治疗手段,但术后必须做好随访工作。Objective To assess the clinical value of loop electrosurgical excision procedure （LEEP） in the diagnosis and treatment of patients with cervical intraepithelial neoplasia （CIN）. Methods Totally 139 CIN patients （confirmed with pathological diagnosis） who were voluntarily treated by LEEP were followed-up for 3 months, 6 months and 2 years after LEEP. The consistent rates between the results of thinPrep cytologic test （TCT）, colposcopy biopsy, and the pathological diagnosis after LEEP were analyzed. The residual lesions after LEEP and recurrent rate were observed. Results The consistent rate of the results of multiple punch biopsy and pathological diagnosis after LEEP was 85.6%. The overall cure rate during the 2-year-follow-up was 95.7%. The residual CIN was found in 1.4% patients, but none occurred within the first 6 months after LEEP. During the 2 years follow-up, the overall cure rates were 99.0% and 88.1% in CIN I and CIN II-III groups, respectively. The residual rates were 1.0% and 2.4%, and the recurrent rates were 0 and 9.5% in CIN I and CIN II-III groups, respectively. In the recurrent patients 3 had HPV16 infection, 2 had HPV16 and 18 infection, and one had HPV53 infection. Conclusion LEEP is a reliable, safe and effective method for diagnosis of CIN and cervical carcinoma in situ, and long-term follow-up is necessary for the patients after LEEP. （Shanghai Med J, 2009, 32： 903-905）

关 键 词：子宫颈上皮内瘤变 高频电波刀子宫颈电圈环切术 随访 

分 类 号：R737.33[医药卫生—肿瘤] R711.32[医药卫生—临床医学]