宫颈Ⅲ型转化区下多点活检+颈管诊刮与诊断性LEEP的适用探讨  

Application of Multiple Cervical Biopsy Combined Endocervical Curettage and Diagnostic LEEP in Cervical Type III Transforming Area

作　　者：马丽莎[1] 邓继红[1] 谭露[1] 张粉 张雯[1] MA Li-Sa;DENG Ji-Hong;TAN Lu;ZHANG Fen;ZHANG Wen(Dept.of Gynecology,Kunming Maternal and Child Health Hospital,Kunming Yunnan 654100,China)

机构地区：[1]昆明市妇幼保健院妇科,云南昆明654100

出　　处：《昆明医科大学学报》2020年第7期99-102,共4页Journal of Kunming Medical University

基　　金：云南省应用基础研究基金资助项目(2017FD241)。

摘　　要：目的通过不同诊断方法对宫颈Ⅲ型转化区CIN检出率的比较,探讨更加合理的分流适用方案。方法选取仅HPV16、18型阳性Ⅲ型转化区100例作为研究对象。均实施宫颈多点活检+ECC,并于活检后1到2个月行LEEP手术,对比两种方法的诊断价值。结果≥45岁组较<45岁组CIN检出率高;≥45岁组中:醋白累及>2个象限列病理升级率较≤2个象限列高,差异有统计学意义(P<0.05)。结论HPV16、18型感染的育龄期女性,Ⅲ型转化区未见醋白时,组织病理学诊断是不必要的;反之同情况围绝经期女性,宫颈多点活检+ECC是必要的,若醋白累及>2个象限,推荐诊断性LEEP。Objective To compare the detection rate of cervical typeⅢtransformation area CIN different diagnostic methods,and to explore more reasonable applicable scheme of shunt.Methods A total of 100 cases of type HPV16,18 positive typeⅢtransformation area were selected as the subjects.Multiple cervical biopsy and ECC were performed,and LEEP surgery was performed 1 to 2 months after biopsy to contrasting the diagnostic value of the two methods.Results The detection rate was higher in the≥45-year-old group than in the<45-year-old group.The pathological escalation rate of Vinegar white epithelium>2 quadrant columns was higher than that of≤2 quadrant columns in the≥45-year-old group,and the difference was statistically significant(P<0.05).Conclusions It is unnecessary to make histopathologic diagnosis when Vinegar white epithelium is not found in typeⅢtransformation area in women of childbearing age with HPV16,18 infection.On the contrary,cervical multi-point biopsy and ECC are necessary in women with perimenopausal period.If Vinegar white epithelium>2 quadrants,diagnostic LEEP is recommended.

关 键 词：型转化区 宫颈多点活检 ECC LEEP CIN 

分 类 号：R737.33[医药卫生—肿瘤]