年轻女性宫颈癌前病变的临床诊治分析

The treatment of cervical precancerous lesions in young females

目的本文主要探讨我院年轻女性宫颈癌前病变的临床诊治现况。方法纳入2013年01月~2017年12月我院收治的行宫颈锥切术的年轻患者(≤35岁),回顾性分析患者的临床病理资料并进行统计学分析。结果(1)共纳入63例患者,年龄自25~35岁不等,平均年龄为30.3±4.2岁。(2)高危型HPV阳性者为49人(78%),其筛查CIN2及以上病变的敏感性为88.5%,特异性为50%。TCT结果为ASC-US以上者为40人(63%),其筛查宫颈病变的敏感性为71.2%,特异性为72.8%。(3)宫颈锥切病理与阴道镜活检病理相比较,诊断相符者为39例(62%),病理级别下降者共13例(21%);病理级别上升者为11例。结论性生活史对于指导年轻女性宫颈癌的筛查意义更大。宫颈锥切术是治疗宫颈癌前病变的有效手段。锥切切缘阳性的年轻患者可选择密切观察或再次锥切,避免过度治疗。

Objective To explore the treatment on cervical intraepithelial neoplasia of young females in The Forth People’s Hospital of Wuxi.Methods The patients younger than 35 years old who under-went cervical conization in our department during January 2013 to September 2017 were involved as the research object.The data were respectively analysed.Results(1)Toally 63 patients were included aging from 25 to 35 years old,averge age was 30.3±4.2 years old.(2)78%showed positive high-risk HPV,the sensitivity on CIN2+screening is 88.5%,the specificity was 50%,while the sensitivity and specificity were 71.2%and 72.8%with ASC-US+of cervical scraping smear,respectively.(3)After conization,the postoperative pathology was decline among 13 patients(21%),rised in 11 patients,and in accordance with the rest 39 patients(62%)when compared with the colposcopy biopsy.Conclusion Sexual life is more important for young females in cervical cancer screening.Cervical conization is an effective treatment of the cervical precancerous lesions.Following up frequently or the second conization for patients with positive margin post-conization seems to be more advisable.