宫颈锥切术在诊治宫颈上皮内瘤变的临床分析

Clinical Analysisi of Conization of Cervix in Diagnosing Cervical Intraepithelial Neoplasia

目的:探讨宫颈锥切术后病理检查对于阴道镜活检病理示宫颈上皮内瘤变(CIN)III级(包括原位癌)的诊断和治疗的临床价值。方法:回顾性分析阴道镜下多点活检为CIN III级及原位癌的患者99例,采用自身对照法,对比阴道镜下多点活检、宫颈锥切术、全子宫切除术的病理结果。结果:68例宫颈锥切术病理后与阴道镜多点活检病理结果符合,符合率为68.7%,17例宫颈锥切术后病理分级降级:炎症10例,CIN II4例,CIN I3例,14例宫颈锥切术后病理分级升级为宫颈癌:IA1 11例,IA2 1例,IB1 2例。对锥切切缘阳性无法随诊、无生育要求或伴有子宫附件疾患、原位癌、宫颈癌等38例患者行子宫切术或根治性子宫切除术,子宫切除术病理符合率为71.05%,两组比较,差异无统计学意义(P>0.05)。结论:宫锥切术具有诊断治疗的双重作用,而且对于阴道镜下活检为CINⅢ级(包括原位癌)的患者,能进一步明确病变程度,是确定下一步治疗方案的不可逾越的过程。

Objective：To research the clinical value of conization of cervix in CIN III by pathologic histology with the help of colposcope. Methods：99 patients who were diagnosed CIN with pathologic histology with vaginoscope were operated on conization of cervix.and compared the pathologic results before and after the operation. Results ： 68 cases were coincident with the result of conization of cervix. The pathologic degree of 14 cases increased after the operation and 17 cases decreased.38 cases of hysterectomy pathology compliance rate was 70%. Conclusion ：Patho- logic histology with Vaginoscope is a simple and effective method for diagnosing CIN, conization of cervix Can remedy the defect of the pathologic histology with vaginoscope and shows a therapeutical effect.