阴道镜宫颈活检联合LEEP术对宫颈癌前病变的诊断评价

Diagnosis value of colposcopy cervical biopsy and LEEP for precancerous lesions of uterine cervix

目的评价阴道镜下宫颈活检联合宫颈环形电切术(LEEP术)对宫颈癌前病变的诊断准确性。方法从2012年7月~2014年7月,收集到我院妇科门诊就诊行阴道镜检查及LEEP术治疗的87例患者。比较阴道镜下宫颈组织活检与LEEP术后组织病理结果。结果阴道镜下宫颈组织活检与LEEP术后组织病理总符合率为74.71%。以LEEP术后组织病理结果为标准,阴道镜诊断CINⅠ符合率为57.14%,诊断CINⅡ符合率为73.68%,诊断CINⅢ符合率为89.26%。其中,诊断CINⅢ的准确率高于CINⅠ(P<0.05)及CINⅡ(P<0.05)。CINⅡ与CINⅠ的差异无统计学意义(P<0.05)。结论阴道镜下宫颈组织活检有漏诊癌前病变及宫颈癌的风险。阴道镜联合LEEP术可实现宫颈癌前病变及宫颈癌的正确诊断。

Objective To study the application of three dimensional visualization technology for laparoscopic resection of cystic carcinoma in pancreatic body and tail.Methods Six cases of cystic carcinoma in pancreatic body and tail are retrospectively analyzed by reviewing clinical data from Nov,2009 to Mar,2011.All the patients' original image data of 64-slice spiral CT are completely collected.Using adaptive region growing algorithm,the serial CT images are segmented and automatically extracted,further we get the 3-dimensional reconstruction mages with the image manipulation software(developed by Fang Chihua).According to the reconstruction,we make the specific surgical approach(the trocar position),surgical procedure,etc.Results The 3-dimensional reconstruction mages clearly presents the cystic carcinoma in pancreatic body and tail and the adjacent organs,especically for the relationship between the cystoma and the splenic artery and vein.All patients are successfully undergone laparoscopic resection of pancreatic body and tail,no perioperative death.Moreover,5 patients preserve the spleen while 1 have to remove the spleen because of mucinous cystadenocarcinoma.The overall rate of pancreatic fistulae is 33.3%,no postoperative hemorrhage.The average hospitalization is 12 days.Conclusion Laparoscopic surgery has the advantage of minimal trauma,quick recovery and high percentage in spleen preserving,ect.The research of 3-dimensional reconstruction of pancreatic CT date is of great application value for laparoscopic resection of cystic carcinoma in pancreatic body and tail.