宫颈上皮内瘤变Ⅲ级不同手术方式效果分析

Effect Analysis on Different Operation Styles on Cervical Intraepithelial Neoplasia Grade Ⅲ

目的探讨宫颈上皮内瘤变Ⅲ级患者手术方式的选择。方法回顾性研究2004年至2012年术前明确诊断宫颈上皮内瘤变Ⅲ级患者103例,采用宫颈锥形切除54例、子宫全切除49例,术后病理检查从手术切缘是否切除干净、上皮下是否有浸润性癌、术后随访观察复发率、HPV转阴率,以此评价手术方式选择是否合理。结果宫颈上皮内瘤变Ⅲ级患者,采用子宫全切与锥形切除,术后手术切缘肿瘤残存与上皮下肿瘤浸润的机率及术后随访病变的复发率、HPV转阴率相差不大,统计学比较无显著差异(P>0.5)。结论宫颈上皮内瘤变Ⅲ级患者,宫颈锥形切除是安全可靠的,宜首先选择。

Objective To explore the selection of the operation styles on cervical intraepithelial neoplasia grade Ⅲ patients. Methods 103 patients with preoperative diagnosis of cervical intraepithelial neoplasia grade Ⅲ between 2004 and 2012 were retrospectively studied. Hysterectomies were performed on 54 cases, and conical cervical resection on 49 cases. We evaluated reasonability of operation style on subtotal resection in postoperative pathologic examination whether cut edge from surgery to remove clean, whether to have invasive carcinoma under the epithelium, and postoperative follow-up recurrence rate, and HPV types negative rate. Results There were no statistically significant between methods of hysterectomy and conical cervical resection on cervical intraepithelial neoplasia of grade Ⅲ by evaluating postoperative surgical cut edge tumor residual and invasive carcinoma under the epithelium, and postoperative follow-up recurrence rate, and HPV types negative rate. （P〉0. 5）. Conclusions For patients with cervical intraepithelial neoplasia grade Ⅲ, conical cervical resection is safe and reliable, and should be the first choice.