宫颈上皮内瘤样变宫颈环形电切术的诊断与治疗价值分析

The Clinical Value of Loop Electrosurgical Exicision Procedure on Diagnosis and Treatment for Cervical Intraepithelial Neoplasia

目的探讨宫颈环形电刀切除术(LEEP)诊断与治疗宫颈上皮内瘤样变(CIN)的临床价值。方法对90例经阴道镜下活检诊断为CIN的患者行LEEP术,采用自身对照法,对比研究阴道镜下活检和LEEP活检病理结果。结果阴道镜下宫颈活检结果与LEEP活检病理学诊断结果的完全符合率为53.33%(48/90),阴道镜下宫颈活检诊断不足27例(30.00%),诊断过度15例(16.67%),两种方法的诊断结果差异有统计学意义(W ilcoxon检验,P=0.018)。结论阴道镜直视下活检对确诊CIN尚不够可靠,阴道镜下活检不能替代LEEP活检。LEEP是诊治CIN的安全有效方法,可以弥补阴道镜下活检的局限性。

Objective To study the clinical value of loop electrosurgical excision procedure（LEEP） on diagnosis and treatment for cervical intraepithelial neoplasia（CIN）.Methods LEEP was performed on 90 patients diagnosed as CIN by colposcopically directed biopsy.The consistency of results of diagnosing CIN by colposcopically directed biopsy and LEEP was evaluated.Results The consistence rate of the diagnosis by colposcopically directed biopsy and that by LEEP was 53.33%（48/90）,with the underdiagnosis rate 30.00%（27/90） and the overdiagnosis rate 16.67%（15/90）.A significant difference between the diagnosis by colposcopically directed biopsy and that by LEEP was found（Wilcoxon test,P=0.018）.Conclusion The accuracy of diagnosing CIN with colposcopically directed biopsy is still unsatisfying.Cervical conization by LEEP can not be instead of colpes copically directed biopsy.LEEP is a safe and effective procedure for the diagnosis and treatment of CIN.