宫颈上皮内瘤变203例处理方法探讨

Study on treatment of 230 cases with cervical intraepithelial neoplasia

目的探讨宫颈上皮内瘤变(CIN)的最好的处理方法,以达到减少漏诊、复发及过治的目的。方法回顾性分析2008年3月至2009年6月在我院诊断为CIN的203例患者的宫颈细胞学涂片、高危型人乳头瘤病毒DNA(HPV-DNA)检测、阴道镜检查结果及术后病理检查结果。结果宫颈上皮内瘤变(HSIL)患者99%为高危型HPVDNA阳性;阴道镜检查结果与活检病理比较,准确率为75%,经宫颈电环切除术(LEEP),术后病理阳性为病变期别减轻为154例,相同的为48例,术后期别加重的为1例。结论三阶梯检查方法可以较好地检出CIN患者,根据期别及生育要求对宫颈治疗,疗效满意。

Objective To study the best way for treatment of cervical intraepithelial neoplasia （CIN） in order to achieve the purpose for reducing rates of missed diagnosis, relapse and over treatment. Methods The clinical data of 203 cases diagnosed as having CIN in patients with cervical cytological smears, high - risk HPV DNA detection, results of colposcopy and postoperative pathological examination during March 2008 to June 2009 in this hospital were retrospectively studied and analyzed. Results 99% of patients with cervical intraepithelial neoplasia（HSIL） were in high - risk with positive HPV - DNA as compared with findings of colposcopy and biopsy results, its accuracy rate was 75%. After loop electro- surgical excision procedure （LEEP）, the grade of pathological lesions was reduced in 154 cases and same in 48 cases, and deteriorated at postop- erative period in 1 case. Conclusion Three step inspection procedure can better detect patients with CIN, and treatment may be carried out ac- cording to the grade of cervical lesions and demands on fertility, and the therapeutic effect is satisfactory.