宫颈高级别上皮内瘤变LEEP术后全子宫切除的病例分析被引量：5

下载PDF

导出

摘要目的评价阴道镜下活检诊断宫颈高级别上皮内瘤变的临床价值,并分析病灶残留与LEEP切缘状态的关系。方法收集近3年来本院107例LEEP术后行全子宫切除患者临床资料,分析其阴道镜下活检、LEEP、切缘及其全子宫切除的病理结果。结果 1阴道镜下宫颈活检结果与LEEP术后病理总体完全符合率为69.2%(74/107),LEEP术后病理诊断升级者占18.7%(20/107),降级者占12.1%(13/107);2 80例切缘阳性者中23例(28.8%)有病灶残留,LEEP切缘阴性27例中有8例(29.6%)发现残留病灶。切缘为微小浸润癌的3例中,切除的子宫标本中均见有癌灶残留。结论单纯的阴道镜活检病理诊断存在一定比例宫颈癌的漏诊,不能代替LEEP术诊断;不能仅以LEEP切缘状态判断病灶残留情况,需综合其他因素进一步评估。

作者谢安龙何春妮

机构地区安徽医科大学福州总医院教学医院(南京军区福州总医院) 南京军区福州总医院妇产科

出处《中国医药指南》 2015年第5期112-113,共2页 Guide of China Medicine

关键词宫颈上皮内瘤变(CIN) 阴道镜活检宫颈电环切除术(LEEP) 全子宫切除术切缘

分类号 R737.33 [医药卫生—肿瘤]

引文网络
相关文献

参考文献1

1周萍,王沂峰.宫颈上皮内瘤变锥切术后残留或复发相关因素Meta分析[J].中国实用妇科与产科杂志,2014,30(7):546-552. 被引量：34

二级参考文献23

1Lu CH, Liu FS, Kuo CJ, et al. Prediction of persistence or recur- rence after conization for cervical intraepithelial neoplasia Ⅲ [J ]. Obstet Gyeeol, 2006,107(4):830-835.
2Alonsoa I, Torn6 A, Luis M, et al.Prc- and post-eonization high-risk HPV testing predicts residual/recurrent disease in pa- tients treated for CIN 2-3 [J]. Gynecol Oncol, 2006,103:631- 636.
3Kietpeerakooll C, Khunamornpong S, Srisomboon J.Cervical in- traepithelial neoplasia Ⅱ - Ⅲ with endocervieal cone margin in- volvement after cervical loop conization:Is there any predictor for residual disease? [J] J Obstet Gynaecol,2011, 33(5):660- 664.
4Jeong-Yeol Parka, Seung Mi Leeb, Chong Woo Yoo.Risk factors predicting residual disease in subsequent hysterectomy follow- ing conization for cervical intraepithelial neoplasia (CIN) Ⅲ and microinvasive cervical cancer [J]. Gynecol Oncol, 2007,107: 39-44.
5Jeong-Yeol Parka, Kyung Hee Lee , Seung Myung Dong, et al. The association of pre-conization high-risk HPV load and the persistence of HPV infection and pe of ccr- vical intraepithelial neoplasia after conization [J]. Gynecol On- col, 2008,108:549-554.
6Lima MI, Tafuri A, Aratjo AC, et al. Cervical intraepithelial neo-plasia recurrence after conization in HIV-positive and HIV- negative women [J]. Inter J Gyneeol Obstet,2009,104(2):100- 104.
7Jeong-Yeol Park, Jaeman Bae, Myong Cheol Lira. Role of high risk-human papilloma virus test in the follow-up of patients who underwent eonization of the cervix for cervical intraepithe- lial neoplasia [J ]. J Gyneeol Oneol, 2009,20(2 ):86-90.
8Claudia Teixeira Lodi,Ma'rcia Antoniazi Michelin,Maria Ine's Li- ma, et al. Factors associated with recurrence of cervical intraepi- thelial neoplasia after conization in HIV-infectcd and noninfect- ed women[J]. Arch Gynecol Obstet, 2011,284:191 - 197.
9Leguevaque P, Motton S, Decharme A, et al.Predictors of recur- rence in high-grade cervical lesions and a plan of manage- ment [J]. EJSO, 2010,36: 1073-1079.
10Torne A, Fuste P, Rodriguez-Carunchio L, et al. Intraoperative post-conisation human papillomavirus testing for early detec- tion of treatment failure in patients with cervical intraepithe- lial neoplasia: a pilot study[J].BJOG,2012:293-299.