摘要
目的:探讨高度宫颈鳞状上皮内病变筛查、早期诊断、治疗方案及预后。方法:对组织病理学诊断的65例宫颈上皮内瘤变(CIN)Ⅱ级和60例CINⅢ级的宫颈细胞学检查、阴道镜检查及多点活检、治疗方法和预后进行回顾性分析。结果:本组125例,细胞学诊断与组织病理学的符合率是82.4%,阴道镜检查符合率是92%。合并高危型人乳头状瘤病毒(HPV)感染者110例,阳性率88%。106例行高频电波刀电圈切除术(LEEP),19例采用宫颈冷刀锥切术(CKC)或全子宫切除术,其中13例年轻尚未生育的妇女因多点CINⅢ或原位癌者行两次LEEP或CKC后行LEEP或LEEP后行全子宫切除术。结论:CIN趋于年轻化;应用宫颈细胞学、阴道镜检查及多点活检,结合HPV-DNA的检测能提高宫颈上皮内病变早期诊断率;对大多数CINⅡ～Ⅲ级的治疗LEEP可作为首选,术后定期随访十分重要,尤其对多个点CINⅢ或原位癌行LEEP或CKC的患者要定期随诊。
Objective：To investigate screening,early diagnosis,therapeutic project and prognosis of high-grade squamous cervical intraepithelial lesion.Methods：The cervical cytology,colposcope,biopsy at multiple sites, methods of therapy and prognosis in 65 patients with cervical intraepithelial neoplasia （CIN） Ⅱ and 60 patients with CIN Ⅲ were analyzed retrospectively.Results：The total accordance rate of the cytology of 125 patients was 82.4% with the pathology.The total accordance rate of colposcope results was 92% .There were 110 patients with human papilloma virus （HPV） infection,the positive rate was 88%.The loop electrosurgical excision procedure（LEEP） were performed in 106 patients and the cold-knife conization （CKC） or complete hysterectomy were performed in 19 patients,13 young patients of whom without child birth were subjected to twice LEEP operations or LEEP operations after CKC or complete hysterectomy after LEEP operations. Conclusion：The age of onset of CIN showed a tendency of being younger.Regular smears of cytology screening,colposcope,biopsy at multiple sites adding to HPV-DNA detected can increase the early diagnostic rate of CIN.LEEP operation was the first therapy for most of CIN Ⅱ and CIN Ⅲ and it is very important in the period of follow-up.The patients with CIN Ⅲ or cervical carcinoma in situ at multiple sites operated with LEEP or CKC should be periodically followed up.
出处
《中日友好医院学报》
2005年第6期328-330,共3页
Journal of China-Japan Friendship Hospital
关键词
宫颈上皮内瘤变
人乳头状瘤病毒
高频电波刀电圈切除术
cervical intraepithelial neoplasia
human papilloma virus
loop electrosurgieal excision procedure
