LEEP活检术在子宫颈病变中的诊断价值

The Value of Biopsy by Loop Electrosurgical Excision Procedure in Diagnosis of Cervical Lesions

目的:探讨LEEP活检术在宫颈病变中的诊断与治疗价值。方法:回顾性分析2004年6月至2006年6月,因宫颈病变同时行宫颈液基薄片细胞学检查、HPV检测及阴道镜下多点活检,多点活检较细胞学检查结果低诊且HPV检测阳性的患者34例,行LEEP活检术,对比研究TCT、LEEP活检术和阴道镜下多点活检的病理检查结果。结果:34例患者LEEP活检结果:炎症4例,CINⅠ6例,CINⅡ11例。CINⅢ10例,AC 2例,SC 1例。LEEP与TCT检查结果符合率:LSIL62.5%,HSIL 93.75%。各型CIN的高危型HPV阳性例数及阳性率分别为CINⅠ2例,33.33%,CINⅡ8例,72.73%,CINⅢ9例,90.00%,癌共3例,100.00%。结论:当阴道镜活检病理结果与TCT不符时,行LEEP活检术,可提高CIN及早期癌的检出率,特别是在高危型HPV感染的患者。

Objective： To study the value of biopsy by loop electrosurgical excision procedure in diagnosis of cervical lesions. Method： Data of 34 cases with cervical lesions diagnosed by biopsy by loop electrosurgical excision procedure were analyzed. All of them were HR - HPV positive, had abnormal cervical smear, received eolposeopy with biopsy. The eolposeopie multiple biopsy was found to be less severe than cervical smear. Result： The result of biopsy by loop eleetrosurgieal excision procedure ： 4 eases of chronic eervieitis, 6 eases of CIN Ⅰ, 11 cases of CIN Ⅱ, 10 cases of CIN Ⅲ, 2 cases with SCC （ squamous carcinoma ）, 1 case with adenocarcinoma （ AC ）. The coincident rate of the diagnosis of TCT cytology and biopsy by loop eleetrosurgieal excision procedure ： LSIL62.5%, HSIL 93.75%. By high - risk HPV testing, 33.33% of CIN, 72.73% of CIN Ⅱ and 90.00% of CIN Ⅲ were positive. Conclusion ： Biopsy by loop eleetrosurgieal excision procedure in diagnosis of cervical lesions can be used to increase efficiency of diagnosis of early cervical cancer and precancerous lesion. It is useful to improve the examination quality, Especially in the eases with high -risk Human papillomavirus （ HR - HPV） infection.