宫颈锥切在宫颈上皮内瘤样病变Ⅲ级中应用的评价

Evaluation of effect of cervical conization on cervical intraepithelial neoplasia Ⅲ

目的:探讨宫颈锥切在宫颈上皮内瘤样病变Ⅲ级(CINⅢ)中诊断与治疗的价值。方法:对广东省妇幼保健院2003～2007年住院治疗的252例CINⅢ患者进行回顾性分析,采用自身对照法,对比研究宫颈锥切术和阴道镜下多点活检的病理检查结果。结果:252例宫颈锥切术与阴道镜下多点活检的病理检查结果符合率74.56%,有32例(12.70%)早期浸润癌,5例(1.98%)浸润癌漏诊。189例(75.00%)宫颈锥切术后密切随诊,在平均为16.4个月的随诊期内,无1例出现宫颈细胞学检查异常,其中3例妊娠并已分娩。结论:宫颈锥切术在CINⅢ诊断和治疗中具有重要的价值,它不能被阴道镜下多点活检所取代,对于要求保留生育功能的年轻CINⅢ患者,是首选的治疗方法,术后密切随访。

Objective ： To explore the value of cervical conization in the diagnosis and therapy of patients with cervical intraepithelial neoplasia m （ CIN Ⅲ ） . Methods： Clinical data of 255 cases with CIN Ⅲ from 2003 to 2007 were analysed retrospectively, a self - controlled study was conducted, the pathologic results of cervical conization and colposcopic muhi - point biopsy were compared. Results ： The pathologic coincidence rate of cervical conization and colposcopic multi - point biopsy was 74.56%. 32 cases （ 12. 70% ） of mieroinvasive cancer and 5 cases （ 1. 98% ） of invasive cancer of cervix were missed. 189 cases （75.00%） after cervical conization were followed up for 16.4 months （average time ）, no cytological abnormality was detected, and 3 cases were pregnant and delivered. Conclusion： Cervical conization plays an important role in the diagnosis and therapy of patients with CIN Ⅲ, which cant be instead of colposcopic multi - point biopsy. Cervical conization is the first choice for the young patients with CIN Ⅲ who demand retention of reproductive function.