Diagnosis and excision of breast multi-focal lesions by ultrasound-guided vacuum-assisted biopsy:a comparative evaluation

Objective To compare and evaluate the efficacy of diagnosis and excision for appropriately selected breast multi-focal lesions and solitary lesion by ultrasound-guided vacuum-assisted biopsy(UGVAB).Methods Among 392 appropriately selected patients,187 patients with multi-focal lesions and 205 patients with solitary lesion were treated by the 8-gauge UGVAB from May 2007 to June 2009.All lesions were removed as completely as possible.The patients with benign pathology underwent physical and ultrasound examinations at one week and 6 months after procedure.Results During the procedure,only three patients had vasovagal syncope and twenty others complained of other intraoperative discomfort.An accurate pathological diagnosis was obtained in all lesions.There was no apparent false-negative result among the 696 lesions with benign pathology at a follow-up of 6 months after procedure.The rates of malignant or premalignant pathology,postoperative complications and residual lesions in patients with multi-focal lesions were higher than those in patients with solitary lesion.If each lesion was considered as a subject of study,there was no significant difference between the two groups.Conclusion UGVAB is an effective method for diagnosis and excision of appropriately selected breast multi-focal lesions and can be used routinely.

Is sentinel lymph node biopsy necessary for the patients diagnosed with breast ductal carcinoma in situ using core needle biopsy or vacuum-assisted biopsy as the initial diagnostic method？

Axillary lymph node status is one of the most important prognostic indicator of survival for breast cancer, especially in ductal carcinoma in situ （DCIS）. The purpose of this study was to investigate whether sentinel lymph node biopsy （SLNB） should be performed in patients with an initial diagnosis of DCIS. Methods： A retrospective study was performed of 124 patients with an initial diagnosis of DCIS between March 2000 and June 2014. The patients were treated with either SLNB or axillary node dissection during the surgery, and we compared the clinicopathologic characteristics, image features, and immunohistochemical results. Results： Eighty-two patients （66.1%） had pure DCIS and 25 （20.2%） had DCIS with microinvasion （DCISM）, 17 （13.7%） updated to invasive breast cancer （IBC）. 115 patients （92.7%） underwent SLNB, among them, 70 patients （56.5%） underwent axillary node dissection. 3 of 115 patients （2.6%） had a positive sentinel lymph node, only 1 （1.4%） of 70 patients had axillary lymph node metastasis, in 84 patients （66.7%） who were diagnosed DCIS by core needle biopsy （CNB） and vacuum-assisted biopsy （VAB）. 26 patients （31.0%） were upstaged into IBC or DCISM in the final histological diagnosis. The statistically significant factors predictive of underestimation were large tumor size, microcalcifications, comedo necrosis, positive Her-2 status, negative estrogen receptor status. Conclusion： The metastasis of sentinel lymph nodes in pure DCIS is very low, but the underestimation of invasive carcinoma in patients with an initial diagnosis of DCIS is an usual incident, especially in the cases when DCIS is diagnosed by CNB or VAB. Our findings suggest patients presenting with a preoperative diagnosis of DCIS associated with large tumor sizes, microcalcifications, comedo necrosis, positive Her-2 status, negative ER status are more likely to be DCISM and IBC in final diagnosis. SLNB should be performed in this part of patients.

New Wireless Handheld Ultrasound-Guided Vacuum-Assisted Breast Biopsy (VABB) Devices: An Important Innovation in Breast Diagnosis

Vacuum-assisted breast biopsy (VABB) plays a fundamental role in the preoperative assessment of breast lesions pro- viding large histology samples that are useful to define diagnoses and biological parameters to guide treatment planning. This technique has been used in our institute since 2000 and two new wireless handheld ultrasound-guided VABB de- vices have been introduced since May 2012. In this report we analyze our experience with these revolutionary devices which are able to provide the option of single-insertion contiguous tissue samples respectively with a 13/14-gauge aperture. Our initial experience on 75 lesions shows that these devices are safe, fast, procedurally advantageous for operators and well accepted by patients. Finally VABB procedures can markedly reduce the need for surgical biopsy.

Efficacy and prognosis of vacuum-assisted excision for benign intraductal papilloma of breast:A meta-analysis

Objective:To evaluate the safety and effectiveness of vacuum-assisted excision for benign intraductal papilloma of breast.Methods:The databases including PubMed,Embase,Cochrane Library,WangFang,CNIK,VIP and Web of Science were searched by computer,according the inclusion and exclusion criteria after screening of literature.The Cochrane handbook and Newcastle-Ottawa scale was used to evaluate the studies.Then the Review Manager 5.3 software was to used analyze the data.Results:A total of 1016 patients was included in 9 articles.The amount of blood loss in vacuum-assisted surgery was less than that in open surgery[MD=-6.38,95%CI(-9.90,-2.86),P<0.05].The drainage[MD=-2.56,95%CI(-4.97,-0.15,P<0.05]and drainage time[MD=-0.25,95%CI(-0.40,-0.09),P<0.05]in vacuum-assisted surgery was less than that in open surgery.There were also few postoperative complications than that in open surgery[RR=0.43,95%CI(0.29,0.64),P<0.05].Compared with open surgery,the postoperative recurrence rate was lower in vacuum-assisted surgery[RR=0.26,95%CI(0.14,0.49),P<0.05].Last,there was no statistically significant difference in the operative time between vacuum-assisted surgery and open surgery,[SD=-12.82,95%CI(-25.70,0.06),P=0.05].Conclusion:Compared with open surgery,vacuum-assisted excision has the advantages of less blood loss and lower postoperative complications,but the operative time is not statistically significant compared with open surgery.In addition,compared with open surgery in this study,vacuum-assisted excision has the advantages of lower recurrence rate,but it still needs long-term dynamic observation.

Efficacy and Safety of Ultrasound Guided Vacuum-Assisted Excision of Fibroadenomas: A Systematic Review

Background: Ultrasound-guided, vacuum-assisted excision [UGVAE] of fibroadenomas is an emerging minimally invasive procedure. UGVAE is being increasingly employed by breast radiologists and surgeons. It has been approved for this use since 2006 by the National Institute for Health and Clinical Excellence in the UK. The aim of this systematic review is to evaluate the efficacy and safety of this procedure based on the up to date available evidence. Methods: A comprehensive literature search of the Cochrane library, Medline, Embase, PubMed, Google scholar, Trip-database, Internet, and the reference lists of relevant articles was performed. We searched for literature with sizeable cases of therapeutic vacuum-assisted excision of fibroadenomas. All prospective studies with more than 20 study participants were screened. The study quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation [GRADE] approach. All were in English. Results: Of the four case series that fulfilled the inclusion criteria there were 516 patients in which 520 procedures were performed. Overall complete excision rate was 89.4%. In two of the studies, this was 100% when the lesions were less than 1.5 cm but reduced to 61% when between 1.5 and 2 cm. Most common significant complication was bleeding with 2 cases of pneumothorax. None of the studies can be regarded as high quality going by GRADE approach. Conclusion: Within the limit of the current published case series, UGVAE appears to be an effective and safe procedure for excision of small fibroadenomas of less than 15 mm in size. A well designed case control study or randomized controlled trials with a sufficient sample size is needed to further assess its safety, effectiveness and more importantly, patients’ satisfaction especially in larger sized fibroadenomas.

Comparison of the underestimation rate in cases with ductal carcinoma in situ at ultrasound-guided core biopsy: 14-gauge automated core-needle biopsy vs 11-gauge vacuum-assisted biopsy

Objective： The objective of this study was to compare the underestimation rate of invasive carcinoma cases with ductal carcinoma in situ （DCIS） at percutaneous ultrasound-guided core biopsies of breast lesions between 14-gauge automated core needle biopsy （ACNB） and 11-gauge vacuum-assisted biopsy （VAB）, and analyze the diagnostic advantages and insufficiencies in DCIS between this two methods, and to determine the relationship between the lesion type （masses or microcalcifications on radiological findings ） and DCIS underestimation rate. Methods： We collected 152 breast lesions which were diagnosed as DCIS by retrospectively reviewing data about ultrasound-guided biopsies of breast lesions （from February 2003 to July 2010）. There were 98 lesions in 95 patients by 14-gauge ACNB, and 54 lesions in 52 patients by 11-gauge VAB （The system used in this study called Mammatome, MMT）. The clinical and radiological findings were reviewed; meanwhile all the selected patients had histological results of the biopsies and follow-up surgeries which also achieved the reliable pathological results to compare with the biopsy results. The differences between two correlated histological results defined as underestimation, and the histological DCIS underestimation rates were compared between the two groups. According to the radiological characteristics, each group was classified into two subgroups （masses or micrecalcifications group）, and the differences between subgroups were also analyzed. Results： The DCIS underestimation rate was 45.9% （45/98） for 14-gauge ACNB and 16.6% （9/54） for MMT. According to the lesion type on ultrasonography, DCIS underestimation was 31.0% （26/84） in masses （43.1% using ACNB and 12.1% using MMT; P = 0.003） and 42.6% （29/68） in microcalcifications （48.9% using ACNB and 23,8% using MMT; P = 0,036）, Conclusion： The underestimation rate of invasive carcinoma in cases with DCIS at ultrasound-guided core biopsies is significantly higher for ACNB than for MMT. Furthermore, this difference does not alter among the two lesion types presented on ultrasonography. So ultrasound-guided VAB （MMT system） could be an effective and useful method for the diagnosis of DCIS lesions no matter what the lesion type is.

Retrospective chart review of skin cancer presence in the wide excisions

AIM: To investigate cancer cell absence or presence in wide excision after biopsy of squamous cell carcinoma(SCC) and basal cell carcinoma(BCC) patients.METHODS: 200 patients(100 BCC and 100 SCC) from the same dermatology clinic, who had positive margin upon biopsy, were selected from a computer generated randomized report. All selected patients had wide excision following biopsy. To determine the correlation of gender, age distribution and cancer absence, BCC and SCC cases were separated based on excision-cancer absent or present after wide excision. χ2 tests, Fisher's exact tests were used to analyze the ratio of male to female between excision-cancer absent and excision-cancer present patients, while Mann-Whitney U test were used to compare the age distribution in the two groups. Statistical analyses were performed using SPSS version 16.0 for Windows.RESULTS: Our retrospective chart review of the patients showed that cancer cells were absent in 49% of BCC patients(n = 100) and 64% of SCC patients(n = 100) who had previously had positive margins upon biopsy. Gender analysis showed the ratio of male to female(M/F) in the BCC arm was significantly higher compared with the SCC arm in those with excision-cancer absent(2.06 vs 0.66; P = 0.004; χ2 test). But M/F of excision-cancer absent and excision-cancer present in neither BCC nor SCC patients was statistically significant. Age adjustment showed no significant difference between excision-cancer absent and excision-cancer present in BCC and SCC patients. Nevertheless, in excision-cancer absent cases, the age distribution showed that the BCC patients were younger than SCC patients(average age 67 vs 74; P < 0.001; Mann-Whitney U test). In addition, our data also indicated that in the patient group of 71-80 years old, there were more SCC patients who showed excision-cancer absence(67.6% vs 39.4%; P = 0.02; χ2 test).CONCLUSION: Our study indicates that approximately 50% or more of BCC and SCC patients with positive margins found on biopsies did not have cancer cells present at the time of wide excisions.

Real-time in vivo distal margin selection using confocal laser endomicroscopy in transanal total mesorectal excision for rectal cancer

BACKGROUND Transanal total mesorectal excision(TaTME)allows patients with ultralow rectal cancer to be treated with sphincter-saving surgery.However,accurate delineation of the distal resection margin(DRM),which is essential to achieve R0 resection for low rectal cancer in TaTME,is technically demanding.AIM To assess the feasibility of optical biopsy using probe-based confocal laser endomicroscopy(pCLE)to select the DRM during TaTME for low rectal cancer.METHODS A total of 43 consecutive patients who were diagnosed with low rectal cancer and scheduled for TaTME were prospectively enrolled from January 2019 to January 2021.pCLE was used to determine the distal edge of the tumor as well as the DRM during surgery.The final pathological report was used as the gold standard.The diagnostic accuracy of pCLE examination was calculated.RESULTS A total of 86 pCLE videos of 43 patients were included in the analyses.The sensitivity,specificity and accuracy of real-time pCLE examination were 90.00%[95%confidence interval(CI):76.34%-97.21%],86.96%(95%CI:73.74%-95.06%)and 88.37%(95%CI:79.65%-94.28%),respectively.The accuracy of blinded pCLE reinterpretation was 86.05%(95%CI:76.89%-92.58%).Furthermore,our results show satisfactory interobserver agreement(κ=0.767,standard error=0.069)for the detection of cancer tissue by pCLE.There were no positive DRMs(≤1 mm)in this study.The median DRM was 7 mm[interquartile range(IQR)=5-10 mm].The median Wexner score was 5(IQR=3-6)at 6 mo after stoma closure.CONCLUSION Real-time in vivo pCLE examination is feasible and safe for selecting the DRM during TaTME for low rectal cancer(clinical trial registration number:NCT04016948).

EnCor旋切系统在多发性乳腺肿物切除活检中的应用

目的 探讨超声引导下EnCor旋切系统在多发性乳腺肿物切除活检中应用价值.方法 对2011年1月至2012年6月我科收治的630例多发性乳腺肿物在超声引导下应用EnCor旋切系统进行微创旋切术,观察手术情况、术后并发症及患者对手术美容效果的满意度.结果 630例患者共成功切除肿物1 728个,术后发现皮下瘀血76例,血肿形成39例;术后6～24个月随访,均未发现病灶残留、复发,美容效果满意.结论 超声引导下微创旋切术是多发性乳腺肿物切除活检的重要方法,具有微创、美观、操作方便、疗效可靠、安全的优点.

超声引导经皮穿刺导丝定位切除乳腺隐匿性病灶的价值

目的探讨经超声引导下钩针定位对手术切除乳腺隐匿性病灶的价值。方法对触诊阴性但超声检查阳性的乳腺和腋窝隐匿性病灶进行靶向钩针穿刺固定,外科手术切除活检,分析病灶良恶性、完全切除率及超声对其诊断的敏感性和特异性,评价该方法对手术时间、术后美容效果的影响。结果61个隐匿性病灶中,恶性病灶16个(26.2%),良性病灶45个(73.8%);所有病灶均完整切除;超声对隐匿性乳腺癌的诊断敏感性93.8%,特异性91.1%。结论超声靶向钩针固定技术可以协助手术准确定位隐匿性病灶,在保证病灶完全清除的前提下缩小手术切除范围,从而早期诊断和治疗乳腺癌。

阴道镜指引下多点活检在宫颈上皮内瘤样病变诊断中的作用

目的:比较阴道镜指引下多点活检与宫颈锥切术后病理结果的差异,评价阴道镜指引下宫颈活检在高级别宫颈上皮内瘤变(CINⅡ,Ⅲ)诊断中的作用。方法:645例阴道镜指引下多点活检病理为CINⅡ及以上级别病变(CINⅡ+)的患者行子宫颈锥切术,对比锥切术前后的病理结果。结果:阴道镜指引下多点活检诊断CINⅡ+敏感度95.0%,特异度46.2%,子宫颈锥切术前后CINⅡ,Ⅲ病理的一致性72.86%,漏诊宫颈浸润癌2.22%。结论:阴道镜指引下子宫颈多点活检是诊断CINⅡ,Ⅲ的一种简单而有效的方法,与子宫颈锥切术后的病理一致性为72.86%,进一步处理的选择应综合评估。

阴道镜指引下宫颈活检与宫颈锥切术后病理结果的比较

目的比较阴道镜指引下多点活检与宫颈锥切术后病理结果的差异,指导CIN2+的临床处理。方法645例阴道镜指引下多点活检病理为CIN2+患者行子宫颈锥切术,对比锥切术前后的病理结果。结果子宫颈锥切术前后CIN2/3病理的一致性为72.86%,漏诊2.22%宫颈浸润癌;CIN2与CIN3患者锥切术后病理升级为鳞状细胞癌的几率差异有统计学意义(0.3%vs.4.4%,P=0.000),CIN2与CIN3患者锥切术后病理降级为低级别病变或炎症的几率差异有统计学意义(39.5%vs.11.3%,P=0.002)。结论阴道镜指引下子宫颈多点活检与子宫颈锥切术后的病理一致性为72.86%,有2.2%的非预期子宫颈浸润癌的可能。

宫颈电圈环切术对宫颈上皮内瘤样病变和宫颈早期浸润癌的诊断价值

目的明确宫颈电圈环切术(loop electro-surgical excisional procedure,LEEP)在宫颈上皮内瘤变及早期浸润癌的诊断价值。方法回顾性分析经"宫颈细胞学-阴道镜下检查-活检后病理组织检查"有宫颈上皮内瘤样病变(cervical intraepithelial neoplasia,CIN)而行LEEP术的患者547例,采用自身对照方法。结果对比研究LEEP术前、术后病理结果,术后病理结果升高49例(8.9%),相同166例(30.3%),降级332例(60.6%),发现镜下早浸癌的3例,浸润癌3例。宫颈电圈术主要并发症是术后出血,颈管粘连。结论宫颈电圈环切术在诊断宫颈上皮内瘤样病变有其优势,在发现宫颈镜下早浸癌方面有其独特的价值。

CIN2/3患者子宫颈锥切前后病理一致性分析

目的:比较CIN2/3患者阴道镜指引下多点活检与子宫颈锥切术后病理结果的差异,评价阴道镜指引下子宫颈活检在高级别子宫颈上皮内瘤变(CIN2,3)诊断中的作用。方法:840例阴道镜指引下多点活检病理诊断为CIN2/3的患者行子宫颈锥切术,对比锥切术前后的病理结果。结果:子宫颈锥切术前后CIN2,3病理的符合率为72.9%,CIN2及CIN3的符合率分别为62.1%、81.8%,阴道镜指引下子宫颈点活检子宫颈浸润癌遗漏几率分别为0.2%及6.6%。结论:阴道镜指引下子宫颈多点活检是诊断CIN2,3的一种简单而有效的方法,与子宫颈锥切术后的病理的符合率较高,但有遗漏子宫颈浸润癌的可能,进一步处理的选择应综合评估。

术前空芯针穿刺活检和开放式手术活检对乳腺癌预后影响的比较研究

目的探讨术前空芯针穿刺活检(CNB)和开放性手术活检(EB)对乳腺癌预后的影响。方法选取2015年5月至2018年5月我院收治的260例早期乳腺癌患者,根据术前诊断方法不同将其分为EB组(n=200)和CNB组(n=60)。比较两组的基线资料,并于术后进行随访,观察患者的无病生存期(DFS),用Cox比例风险模型对可能影响患者预后的因素进行分析。结果 CNB组肿瘤直径>2 cm比例明显高于EB组(P <0.05); CNB组与EB组活检至手术间隔时间比较有统计学差异(P <0.05)。Cox回归分析显示,乳腺癌DFS的主要影响因素为ER、 HER-2表达及淋巴结转移。结论与EB相比,对乳腺癌患者行术前CNB不影响其预后,值得临床推广。

Preoperational diagnosis and management of breast ductal carcinoma in situ arising within fibroadenoma:Two case reports

BACKGROUND Ductal carcinoma in situ(DCIS)arising within fibroadenoma is a type of tumor that is rarely encountered in clinic,with only about 100 cases of carcinoma arising within a fibroadenoma reported in the literature.Here,we present two cases of breast DCIS arising within a fibroadenoma and discuss their clinical and imaging findings as well as treatment.CASE SUMMARY The patients did not have cancer-related personal and family histories.Case 1(a 49-year-old woman)was diagnosed with a bilateral breast nodule in May 2018 and was followed(preoperative imaging data including ultrasound and mammography)for 3 years;she underwent an excisional biopsy to address an enlargement in nodule size.Case 2(a 37-year-old woman)was diagnosed with a left breast nodule in June 2021 and consequently received vacuum-assisted biopsy of the tumor which appeared as“irregularly shaped”and“unevenly textured”tissue on ultrasound.The pathological diagnosis was clear in both cases.Both patients underwent breast-conserving surgery and sentinel lymph node biopsy.The two cases received or planned to receive radiotherapy as well as endocrine therapy(tamoxifen).CONCLUSION Breast DCIS arising within a fibroadenoma is rare,but patients treated with radiotherapy and endocrine therapy can have good prognosis.

超声引导真空辅助旋切与局部扩大切除治疗乳腺良性叶状肿瘤的疗效比较

目的比较超声引导真空辅助旋切术(vacuum-assisted excisional biopsy,VAB)与传统局部扩大切除术(wide local excision,WLE)治疗3 cm以下乳腺良性叶状肿瘤(phyllodes tumor,PT)的疗效。方法回顾性分析2014年7月~2020年3月94例乳腺良性叶状肿瘤资料,其中VAB组22例,WLE组72例。结果94例均顺利完成手术,共切除叶状肿瘤103枚,超声均确认病灶完全切除,无术中并发症。排除9例伴不典型增生及3例伴原位癌,VAB组19例中位随访47个月(14~80个月),局部复发率15.8%(3/19);WLE组63例中位随访33个月(12~80个月),局部复发率11.1%(7/63)。2组局部复发率差异无统计学意义(log-rankχ^(2)=0.214,P=0.644)。WLE组切缘阴性者局部复发率为9.4%(3/32),切缘阳性者为12.9%(4/31),差异无统计学意义(χ^(2)=0.002,P=0.964)。结论超声引导VAB治疗乳腺良性叶状肿瘤安全有效。

Assessment of lymph node involvement in colorectal cancer

Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node metastasis staging system. Patients with nodenegative disease have 5-year survival rates of 70%-80%, implying a significant minority of patients with occult lymph node metastases will succumb to disease recurrence. Enhanced staging techniques may help to identify this subset of patients, who might benefit from further treatment. Obtaining adequate numbers of lymph nodes is essential for accurate staging. Lymph node yields are affected by numerous factors, many inherent to the patient and the tumour, but others related to surgical and histopathological practice. Good lymph node recovery relies on close collaboration between surgeon and pathologist. The optimal extent of surgical resection remains a subject of debate. Extended lymphadenectomy, extra-mesenteric lymph node dissection, high arterial ligation and complete mesocolic excision are amongst the surgical techniques with plausible oncological bases, but which are not supported by the highest levels of evidence. With further development and refinement, intra-operative lymphatic mapping and sentinel lymph node biopsy may provide a guide to the optimum extent of lymphadenectomy, but in its present form, it is beset by false negatives, skip lesions and failures to identify a sentinel node. Once resected, histopathological assessment of the surgical specimen can be improved by thorough dissection techniques, step-sectioning of tissue blocks and immunohistochemistry. More recently, molecular methods have been employed. In this review, we consider the numerous factors that affect lymph node yields, including the impact of the surgical and histopathological techniques. Potential future strategies, including the use of evolving technologies, are also discussed.

阴道镜下宫颈活检联合LEEP术对宫颈鳞状上皮内病变诊治的临床价值

目的探讨阴道镜下宫颈活检联合宫颈环形电切术(LEEP)对宫颈鳞状上皮内病变(SIL)诊治的临床价值。方法 80例经常规妇科检查、阴道镜、宫颈脱落细胞学检查、人乳头瘤病毒(HPV)检测等初查确定为宫颈病变的患者,均行阴道镜下宫颈活检及LEEP术。观察患者的手术情况,比较阴道镜下宫颈活检及LEEP术的检出情况,观察患者的术后复查结果。结果 80例患者的平均手术时长(6.47±3.70)min,平均出血量<20 ml。80例患者中,阴道镜下宫颈活检与LEEP术后标本病理诊断的符合率为56.25%(45/80);在阴道镜下宫颈活检后进行LEEP术发现, 10例宫颈上皮内瘤变(CIN)Ⅰ患者有3例符合,符合率为30.00%,其中7例病理诊断级别升高(CINⅡ/CINⅢ);34例CINⅡ患者有11例符合,符合率为32.35%,其中15例病理诊断级别升高(CINⅢ), 8例病理诊断级别降低(CINⅠ);36例CINⅢ患者有31例符合,符合率为86.11%,其中1例病理诊断级别升高(微小浸润癌), 4例病理诊断级别降低(CINⅠ/CINⅡ)。阴道镜下宫颈活检联合LEEP术的检出率82.50%(66/80)高于阴道镜下宫颈活检的56.25%(45/80),差异有统计学意义(P<0.05)。术后3个月患者门诊复查,有3例患者已接受全子宫切除手术,其他77例患者行宫颈外观检查,其中有72例患者宫颈表面光滑,外形已无任何异常, 5例患者的宫颈外形尚未恢复。结论阴道镜下宫颈活检与LEEP术联合、互补,进一步减少漏诊率,使疾病得到早发现、早诊断、早治疗,是防治宫颈癌的关键。

镜下多点活检联合宫颈管搔刮与LEEP术治疗CIN

目的探究在宫颈上皮内瘤变(CIN)中应用阴道镜下多点活检、宫颈管搔刮检查,并同时进行宫颈环形电切术(LEEP)的诊治效果。方法将2018年1月-2019年12月期间在本院接受液基细胞学筛查(TCT)检测异常的96例患者纳入研究,均进行阴道镜下多点活检、宫颈管搔刮,并对其中阴道镜下诊断为CIN的78例患者进行LEEP术治疗及术后病理检查,观察诊断结果。结果阴道镜下检查与术后病理诊断在CIN分型中无显著差异(P> 0.05);78例CIN患者均顺利完成LEEP手术;手术时间10~30 min,平均(18.16±5.86)min;术中出血量10~50 mL,平均(21.58±5.17)mL;手术疗效:治愈77例(98.72%);残留1例(1.28%);复发3例(3.85%);发生并发症2例(2.56%);术后血清IL-6水平低于术前,差异显著(P <0.05)。结论阴道镜下多点活检联合宫颈管搔刮可为LEEP手术提供诊断依据,促进手术的顺利,同时LEEP术在CIN患者中具有较好的治疗效果。