探讨宫颈上皮内瘤样病变的诊断及治疗方法

nvestigation of diagnosis and treatment method of cervical intraepithelial neoplasia

宫颈上皮内瘤样病变(CIN)是指子宫颈上皮非典型增生至原位癌这一系列癌前病变的连续过程,近年CIN及宫颈癌的发病率增加且患者年龄趋于年轻化,因此及时正确诊断CIN并得到合适的治疗尤为重要。CIN的诊断有传统巴氏涂片法、液基细胞学(TCT)检查、人乳头瘤病毒(HPV)检查、阴道镜检查、宫颈活检等多种方法 ,其中阴道镜因其准确性高、无创伤、可重复操作等特点,是目前诊断宫颈病变的重要方法。常用的CIN治疗方法有物理治疗和手术治疗。物理治疗方法包括CO2激光治疗、冷冻治疗、电凝治疗等。手术治疗包括宫颈锥切术和全子宫切除术等。宫颈电圈切除术(LEEP)由于其治疗时间短、操作简单、损伤小,更加深入大范围治疗病变部位,切除组织可以送病理学检查等,已成为宫颈癌前病变及早期宫颈癌治疗的主要方法。

Cervical intraepithelial neoplasia （CIN） refers to continuously precancerous lesions process from cervical epithelial atypical hyperplasia to carcinoma in situ. In recent years, the morbidity rates of CIN and cervical cancer have increased, and the patients tend to be younger. Therefore, it is important to have CIN correctly diagnosed and properly treated. The traditional Pap smear, thinprep cytology test （TCT）, examination of human papilloma virus （HPV）, colposcopy test, and cervical biopsy are the main diagnosing methods of CIN. Due to the features of high accuracy, non-invasion, and repeatable operation, colposcopy is the major method in diagnosis of cervical lesions. The common CIN treatment methods include physical therapy and operation therapy. CO2 laser therapy, cryotherapy, and electric coagulation therapy are included in the physical therapy, and cervical conization and hysterectomy are the operation therapy. Loop electrosurgical excision procedure （LEEP） has become the main treatment method for precancerous lesions of cervical cancer and early-stage cervical cancer, because of its characteristics of short treatment time, simple operation, less damage, deeper and wider range of lesions treatment, and pathological examination of the resected tissues.