宫颈上皮内瘤样病变Ⅲ级的治疗与预后分析

The Prognosis and Treatment of Cervical Intraepithelial Neoplasia Ⅲ

目的:探讨宫颈上皮内瘤样病变Ⅲ级(CINⅢ)的治疗方法及其预后。方法:对1988年1月至2005年1月在我院治疗的CINⅢ患者124例进行回顾性分析,其中宫颈原位癌48例,宫颈重度不典型增生76例。结果:原位癌患者中,行次广泛全子宫切除术的29例和全子宫切除术的11例,术后均无复发;6例行宫颈锥形切除术,1例术后9年再次发生原位癌;重度不典型增生的患者,49例行子宫切除术,27例行锥切术,术后患者均无复发。结论:全子宫切除术与次广泛全子宫切除术预后相近,全子宫切除术可作为原位癌患者的首选治疗方法,单纯宫颈锥切术有术后复发可能,术后应严密随访;重度不典型增生可行宫颈锥切术或LEEP手术,术后应定期随诊。

Objective： To explore the prognosis and treatment of cervical intraepithelial neoplasia Ⅲ（CIN Ⅲ）. Method： We analyzed 124 cases with CIN Ⅲ from Jan. 1988 to Jan. 2005. In all of them 48 cases with cervical carcinoma in situs 76 cases with cervical serious atypical hyperplasia. Result： In all with cervical carcinoma in situs, 29 cases underwent part hysterectomy, 11 cases underwent total hysterectomy. There＇s no recurrence in all 6 cases taken cervical conization, one of them occurred cervical carcinoma in situs after 9 years. In the cervical serious atypical hyperplasia patients, 49 cases with total hysterectomy, 27 cases with cervical conization. There＇s no reccurrence. Conclusion： It＇s similiar of the prognosis in total and part hysterectomy. It＇s the best to undergo total hysterectomy in cervical carcinoma in situ patients. It＇s possible to occure again with simply cervical conization. So it＇s necessary to follow up. It＇s important to undergo cervical conization or with LEEP for the cervical senions atypical hyperplasia, and the terminal follow up is necessary.