子宫颈锥形切除术病理结果分析

Clinical Analysis for the Results of Pathological Examination in Cervical Conization

目的:对照子宫颈锥形切除术与活检的病理结果,探讨重度子宫颈上皮内瘤变(CIN-Ⅲ)的临床处理方法。方法:分析在阴道镜下活检,病理诊断为CIN-Ⅲ,行子宫颈锥形切除术的患者153例,采用自身对照的方法,对比子宫颈锥形切除术后的病理结果。结果:子宫颈锥形切除术与阴道镜下活检病理诊断相符者95例,占62.09%:不相符者58例,占37.91%:其中诊断升高为子宫颈浸润癌16例,占10.46%;诊断降低者42例,占27.45%,最终诊断以病理诊断级别高者为准。结论:子宫颈锥形切除术与阴道镜下活检病理诊断仍有一定的差异,重度子宫颈上皮内瘤变(CIN-Ⅲ)的病例,建议行子宫颈锥形切除术进行最终诊断与治疗。

Objective: To evaluate the clinical management of cervical intraepithelial neoplasia Ⅲ(CINⅢ) by comparative study on the results of pathological examination between colposcopic multiple biopsies and cervical conization specimens. Methods: A 3-year retrospective study was conducted in 153 patients with CINⅢ. The correlation between colposcopic multiple biopsies and cervical conization specimens were analyzed. Results: In comparison with pathological examination results of biopsies with cervical conization, the correlation was accurate in 95 of 153 case(62.09%), but there was not correspondence in 58 of 153 case(37.91%). The colposcopic multiple biopsy was found to be more or less severe than cervical conization in 42 cases(27.45%) and 16 cases(10.46%) respectively. Sixteen cases with invasive cancer were missed at the time of colposcopy and biopsy but subsequently diagnosed by conization. Conclusion: There is a discrepancy between the result of pathological diagnosis for cervical conization and for colposcopic multiple biopsies. We suggest that patients with cervical conization be conducted on CINⅢ for final diagnosis and treatment.