宫颈高级别病变“即诊即治”的可行性分析

The feasible analysis of “immediate treatment” strategy for patients with cervical high-grade lesions

目的回顾性分析宫颈病变的各项检查结果,探讨宫颈高度病变"即诊即治"价值。方法选取经LEEP治疗后病理结果为CIN2及CIN3 194例,对其资料进行回顾性分析,对比研究TCT、阴道镜拟诊、宫颈活组织检查结果。结果 TCT结果HSIL 38例(19.59%),ASC-H 35例(18.04%),LSIL 44例(22.68%),ASC-US 66例(34.02%),炎症11例(5.67%)。阴道镜拟诊HSIL 124例(63.92%),宫颈活组织检查高级别病变185例(95.36%)。TCT为HSIL及炎症的患者,阴道镜拟诊和宫颈活组织检查高级别病变的检出率差异无统计学意义(P>0.05)。TCT为其他结果的患者,高级别病变检出率差异有统计学意义(P<0.05)。结论宫颈病变筛查以三阶梯法为主,对于TCT为HSIL,阴道镜拟诊仍HSIL的患者可以直接行LEEP术。

Objective To discuss the value of ＂immediate treatment＂ strategy in women with high grade squamous intraepithelial lesions（HSIL）.Methods Data of 194 patients with CIN2 or CIN3 diagnosed by pathologist after LEEP were restrospectively analyzed.Their results of TCT,colposcopy and cervical biopsy were compared pre-and-post LEEP treatment.Results There were 38 cases（19.59%）of HSIL,35 cases（18.04%）of ASC-H,44 cases（22.68%）of LSIL,66 cases（34.02%）of ASCUS and 11 cases（5.67%）of inflammation in TCT group.124 cases（63.92%）of HSIL were diagnosed after colposcopy and the cervical biopsy identified 185 cases（95.36%）of high-grade lesions.For those HSIL and inflammation of TCT results,the detection rates of highgrade lesions had no significant different compared with colposcopy and cervical biopsy results（P＆gt;0.05）.For the TCT results of ASC-H,LSIL and ASC-US,the detection rates of high-grade lesions were statistically different by colposcopy and cervical biopsy（P＆lt;0.05）.Conclusion Traditional three-step method is primary screening and treatment for CIN, but＂immediate treatment＂method may be considered for patients with HSIL by TCT and colposcopy.