高度宫颈上皮内瘤变累及腺体患者与未累及腺体患者临床对比分析  

Clinical analysis of patients with high grade cervical intraepithelial neoplasia involving glands and not involving glands

作　　者：张倩雯[1] 封全灵[1] 张钦山 刘弘扬[1] 律欢欢 

机构地区：[1]郑州大学第三附属医院暨河南省妇幼保健院妇科,450052

出　　处：《中国实用医刊》2016年第3期67-68,共2页Chinese Journal of Practical Medicine

摘　　要：目的研究高级别宫颈上皮内瘤变（CIN2—3）累及腺体患者与未累及腺体患者在临床病理及术后复发方面有无差异。方法回顾性分析郑州大学第三附属医院2010年至2012年宫颈活检诊断为CIN2～3患者的临床资料182例，分为CIN2～3未累腺组68例和CIN2～3累腺组114例，两组均行宫颈冷刀锥切术，采用自身对照法对比以上两组术后与术前病理降级率、符合率、升级率以及术后随访中病变累计持续／复发率。结果①病理结果：两组手术前后病理降级率、符合率、升级率分别为17．6％、79．4％、2．9％及15．7％、73．6％、10．5％，两组间比较差异未见统计学意义（P=0．177）。②累计随访异常率：未累腺组3例（4．41％），累腺组6例（5．45％），两组比较差异亦未见统计学意义。结论CIN2～3累腺患者并未比未累腺患者在病理分布中表现出更高的浸润性、隐蔽性，也未表现出更高的术后复发率，在临床治疗中可做同等对待。对于高级别CIN无论是否累及腺体，术后都应加强宣教，降低宫颈癌发病率。Objective To figure out whether CIN（cervical intraepithelial neoplasia） 2 -3 patients and CIN 2 -3 glands affected patients have differences in terms of clinical pathology and postoperative recurrence. Methods The clinical data of 182 CIN 2 -3 patients who were diagnosed via cervical biopsies in the third affiliated hospital of Zhengzhou universi- ty from 2010 to 2012 were retrospectively aralyzed. According to the diagnoses of preoperative biopsies, the CIN2 -3 patients were divided into two groups, one was the glands not affected group（68 cases） , and the other was the glands affected group（ 114 cases）. The two groups were performed cervical cold knife cone cut method. By means of self-control method, the contrast can be made between different groups in terms of postoperative pathologic degradation ratio, coincidence rate, upgrade rate, and diseased cumulative sustained rate or recurrence rate in the postoperative following-up. Results ①The pathological results： This paper compared those glands not affected patients with those affected under the premise that they all underwent the cervical conization. And there was no significant difference between them in postoperative pathologic degradation ratio, coincidence rate, upgrade rate（ P = 0. 177 ）. ②The abnormal rate of cumulative following-up ： there were 3 cases of recurrence of CIN 2 -3 glands not affected patients whose ratio was 4. 41% （3/68） while 6 cases of those glands affected with the rate of 5.45% （6/110）. Conclusions CIN 2 -3 glands not affected patients and CIN 2 -3 glands affected patients in the distribution of pathology showed no more invasive, concealment, and did not show a higher postoperative recurrence rate. In the clinical treatments, they can be treated in the same way. The postoperative follow-ups are vital no matter whether involving glands.

关 键 词：宫颈上皮内瘤样病变 累及腺体 子宫颈锥形切除术 

分 类 号：R737.33[医药卫生—肿瘤]