宫颈上皮内瘤变及宫颈癌272例临床分析

Clinical analysis of cervical intraepithelial neoplasia and cervical cancer

目的通过分析272例宫颈病变患者的临床资料,探讨宫颈病变的诊断及治疗方法。方法回顾分析CIN2/3级178例及宫颈癌94例,对比年龄、临床表现、症状、组织病理结果及治疗方法。结果 CIN2/3级年龄峰值为30～50岁,有阴道出血表现者71例(39.9%)宫颈癌的年龄峰值后移至40岁以上,有阴道出血表现者68例(72.3%)。CIN患者术前术后病理结果完全诊断一致者122例(68.5%),遗漏15例(8.4%)宫颈浸润癌。125例CIN2/3行宫颈锥切术,CIN2和CIN3的切缘阳性率分别为6.45%(2/31)和24.47%(23/94),18例宫颈锥切术后行全子宫切除标本发现CIN残留3例。结论对宫颈癌患者的筛查应根据性生活情况提前到30岁以前,对阴道出血及宫颈糜烂患者要高度重视,阴道镜活检有助于早期诊断,但也存在一定漏诊率。宫颈锥切术可作为CIN2/3患者的首选治疗方法。

Objictive Analyzed 272 cases clinical data of patients with cervical lesions,to explore the diagnosis of cervical lesions and treatment.Methods Retrospective analysis of 94 cases of cervical cancer cases and CIN2/3 178 cases,compared the age,clinical manifestations,symptoms,pathological findings and treatment.Results CIN2/3 peak age of 30-50 years old,71 cases of vaginal bleeding,the peak age of cervical cancer over the age of 40,there were 68 cases of vaginal bieeding,CIN diagnosis before and after surgery entirely consistent with pathological findings in 122 cases,missing 15 cases invasive cervical cancer.125 cases of CIN2 / 3 cervical conization,CIN2 and CIN3 in the positive margin rate was 6.45% and 24.47% After 18 cases of cervical conization hysterectomy specimens found in 3 cases of residual CIN.Conclusions Screening for cervical cancer should be based on the living conditions of sex before age 30 in advance,Should attaches great importance to the vagina bleeding and the cervical erosion,colposcopy biopsy in early diagnosis,but there are some missed diagnosis.Conization as CIN2/3 the first choice for treatment of patients.