LEEP治疗宫颈上皮内低度瘤样病变153例临床分析

Clinical analysis of 153 cases of CIN Ⅰ treated by LEEP

目的：探讨LEEP治疗宫颈上皮内低度瘤样病变（CINI）的临床价值及意义。方法：收集2004年1月～2006年11月来我院子宫颈疾病诊治中心（国家子宫颈癌早诊早治示范基地）就诊，阴道镜下活检，病理确诊为CINI的病例531例，对其中自愿行LEEP术治疗的153例病例进行临床分析，采用自身对照，对比研究阴道镜下多点活检和LEEP术后的病理检查结果。结果：阴道镜下多点活检和宫颈LEEP术后病理结果的符合率为87．58％，宫颈LEEP术后病理降级为慢性宫颈炎，宫颈湿疣样变的有56例，占36．60％，其中HPV阳性14例（25．00％）；宫颈LEEP术后病理保持为CINI的有78例，占50．98％，其中HPV阳性42例（53．85％）；宫颈LEEP术后病理升级的有19例，占12．42％，其中CIN Ⅱ有12例，占7．84％，CIN Ⅱ级以上有7例，占4．58％，其中包括1例原位癌，1例镜下早期浸润癌。病理升级病例中HPV阳性率为100％。结论：对HPV阳性的CIN I患者实施LEEP治疗有重要的临床价值，不仅可以达到治疗的目的，更可以避免因阴道镜下活检遗漏更高级别的宫颈病变甚至宫颈癌的进一步发展。

Objective:To investigate the clinical value and significance of treating CIN Ⅰ with LEEP.Methods:Collected 531 cases of CIN Ⅰ identified by pathological diagnosis from January 2004 to November 2006 in our diagnosis and treatment centre of cervical diseases(national cervical cancer early diagnosis and treatment demonstration base),153 cases of them who acceptting LEEP treatment voluntarily were carried out clinical analysis,self-control was used to compare and study the results of multiple punch biopsy through colposcopy and pathological check after LEEP.Results:The coincidence was 87.58% between results of multiple punch biopsy through colposcopy and pathological check after LEEP.There were 56 cases of pathological results down-graded to chronic cervicitis accounting 36.60%,among which,there were 14 cases of HPV positive(25%);There were 78 cases of pathological results remained as CIN Ⅰaccounting 50.98%,among which,there were 42 cases of HPV positive(53.58%);There were 19 cases of up-grade pathological results accounting 12.42%,among which,there were 12 cases of CIN Ⅱ(7.84%);7 cases of more than CIN Ⅲ(4.58%) including 1 case of CIS and 1 case of micro invasive carcinoma.They were all HPV positive(100%).Conclusion:It is very significant to treat patients of CIN Ⅰ with HPV positive by LEEP.It not only can cure the disease but also can avoid the development of much more serious cervical diseases such as cervical carcinoma may be ommited just by multiple punch biopsy through colposcopy.