高频电波刀电圈切除术在宫颈CINⅢ及宫颈癌Ⅰ_(A1)诊治中的应用价值被引量：10

Loop electrosurgical excision procedure for treatment of CINⅢ and cervical carcinoma stage Ⅰ_(A1)

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摘要背景与目的:高频电波刀电圈切除术已经广泛应用于宫颈上皮内瘤变(cervical intraepithelial neopla-sia,CINⅢ)的诊治中。本研究主要探讨高频电波刀电圈切除术对CINⅢ及宫颈癌ⅠA1患者的诊治作用。方法:回顾性分析本院2003年1月至2006年10月396例经阴道镜下宫颈活检后病理证实为CINⅢ及宫颈癌ⅠA1且手术治疗的临床资料,将阴道镜下宫颈活检、LEEP(high frequency loop electrosurgical excision procedure)手术后的病理与进一步手术治疗后病理进行分析比较。结果:宫颈多点活检准确率为88.6%(351/396),级别不同程度升高者45例(11.4%);LEEP术前宫颈多点活检准确率88.3%(121/137),级别不同程度升高者16例(11.7%),切缘阳性者标本残留率为10.2%(6/59)、阴性者则为7.7%(6/78);LEEP手术后病理诊断准确率99.3%(136/137),级别不同程度升高者1例(0.7%)。结论:阴道镜下多点活检有一定的假阴性率,LEEP手术可提供完整的病理标本,手术前行LEEP手术有助于提高宫颈CINⅢ及宫颈癌ⅠA1诊治准确性,切缘阳性者易有残留,术后应适当处理。 Background and purpose： High frequency loop electrosurgical excision procedure（LEEP） has been widely used in the treatment of cervical intraepithelial neoplasia. The purpose of this study was to explore the value of loop electrosurgical excision procedure in the diagnosis and management of CINⅢ and stage ⅠAI, cervical carcinoma. Methods： A retrospective analysis was carried out in 396 cases of CINⅢ and cervical carcinoma with stage ⅠAI undergoing operation and loop electrosurgical excision procedure between January 2003 and October 2006 at Obstetrics and Gynecology Hospital of Fudan University. Results： The coincidence rate of the multiple biopsies before the procedures compared with the coniza- tion ones was 88.6 % （351/395）. The incidence of residual disease was 10.2% （6/59） and 7.7 % （6/78）, respectively in patients with positive margins and negative margins. Conclusions： Loop electrosurgical excision procedure can improve both the diagnosis and treatment of CINⅢ and cervical carcinoma stage ⅠAI. We should offer further treatment properly to the cases with positive margin because of the persistent lesions.

作者朱芝玲鹿欣

机构地区复旦大学附属妇产科医院妇科

出处《中国癌症杂志》 CAS CSCD 2007年第6期476-478,共3页 China Oncology

关键词高颇电波刀电圈切除术宫颈上皮内瘤样病变宫颈肿瘤 loop electrosurgical excision procedure cervical intraepithelial neopiasia cervix neoplasm

分类号 R737.33 [医药卫生—肿瘤] R730.56 [医药卫生—肿瘤]

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