宫颈锥切术联合术中冰冻病理检查在高级别宫颈上皮内瘤变诊断与治疗中的价值

Value of conectomy combined with intraoperative frozen pathological examination in diagnosis and treatment of high-gradecervical intraepithelial neoplasia

目的观察在高级别宫颈上皮内瘤变(CIN)患者中实施宫颈锥切术联合术中冰冻病理检查的效果。方法选取45例高级别宫颈上皮内瘤变患者,患者均进行阴道镜活检病理诊断,比较不同诊断结果。结果术中冰冻病理诊断及术后石蜡病理诊断比较差异无统计学意义(P>0.05)。阴道镜下活检及术后石蜡病理诊断比较,差异有统计学意义(P<0.05)。在阴道镜多点活检诊断中,术中冰冻病理诊断符合率为88.9%(40/45),术后石蜡病理诊断符合率为33.3%(15/45),比较差异有统计学意义(P<0.05)。宫颈上皮内瘤变及浸润癌诊断实施宫颈锥切术高达88.9%(40/45),治愈率高达95.6%(43/45);术后总体病灶残留率为4.4%(2/45)。结论对高级别宫颈上皮内瘤变患者实施宫颈锥切术具有重要意义,经术中冰冻病理进行诊断分析,可以提升疾病诊断准确率及临床效果。

Objective To observe the effect of cervical conectomy combined with intraoperative frozen pathological examination in patients with high-grade cervical intraepithelial neoplasia(CIN).Methods 45 patients with high-grade cervical intraepithelial neoplasia were selected,all of whom underwent colposcopic biopsy for pathological diagnosis,and the different diagnosis results were compared.Results There was no significant difference in the pathological diagnosis of intraoperative freezing and postoperative paraffin wax(P>0.05).There was significant difference between colposcopic biopsy and postoperative paraffin pathology(P<o.05).In colposcopic multi-point biopsy diagnosis,the coincidence rate of intraoperative frozen pathological diagnosis was 88.9%(40/45),and that of postoperative paraffin pathological diagnosis was 33.3%(15/45),the difference was statistically significant(P<0.05).The diagnosis of cervical intraepithelial neoplasia and invasive carcinoma was 88.9%(40/45),and the cure rate was 95.6%(43/45).The overall residual rate was 4.4%(2/45).Conclusion It is of great significance to perform cervical conectomy for patients with high-grade cervical intraepithelial neoplasia,and diagnosis and analysis through intraoperative freezing pathology can improve the accuracy of disease diagnosis and clinical effect.