宫颈冷刀锥切术治疗328例CINⅢ的临床分析被引量：17

Clinical Analysis of 328 Patients with CIN Ⅲ Treated by Cold Knife Conization

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摘要目的:评价宫颈冷刀锥切术(CKC)对阴道镜下活检结果为CINⅢ的患者的诊治价值。方法:回顾性分析1997年1月至2005年12月行冷刀锥切术治疗的328例阴道镜下活检结果为CINⅢ的患者的临床资料。结果:锥切术后病理检查发现263例(80·2%)有CINⅢ病灶存在;12例(3·7%)有癌灶浸润。切缘阳性22例(7·0%),其中2例切缘CINⅢ患者行再次手术;1例切缘CINⅢ患者随访30个月发生浸润癌;另4例切缘CINⅢ、3例切缘CINⅡ和12例切缘CINⅠ要求观察,随访CIN病灶自然消退。切缘阴性患者294例(93·0%),6例(1·9%)复发,其中2例复发CINⅢ的患者接受再次手术;另1例复发CINⅡ和3例复发CINⅠ未处理,随访CIN病灶消退。结论:宫颈冷刀锥切术能提高宫颈病变诊断准确性,避免漏诊宫颈浸润癌;也是治疗CINⅢ的有效方法,但对切缘阳性的处理仍有待商榷。 Objective.To evaluate the value of diagnosis and therapy of cold Imife conization （CKC） in treatment of ClN Ⅲ diagnosed under colpescopy. Methods：A retrospective analysis of the clinical data was carried out in 328 cases with CIN Ⅲ underwent CKC from January 1997 to December 2005,and all patients had pathological diagnosis under colpescopy multiphase biopsy.Pesults. 263 （80.1%） cases had histopathological diagnosis of CIN Ⅲ in CKC, 12（3.7%） patients had invasive carcinoma. 22 （7.0%） patients had positive margins, 2 of CIN Ⅲ underwent subsequent operation, 1 of ClN Ⅲ lesion developed invasive carcinoma after 30 months of follow-up, another 4 of CIN Ⅲ, 3 of CIN Ⅱ, and 12 of CIN I regressed to normal dunng follow-up. In 294 （93.0%） patients with negative margin, 6 （1.9%） patients relapsed, 2 of them with CIN Ⅲ ware carded out subsequent operation, 1 of CIN ]f and 3 of CIN I undispesed were found lesions subside during follow-up. Conclusions：CKC can improve accura- cy of the diagnosis of ClN Ⅲ, and avoid the missed diagnosis, and is also an effective treatment to ClN Ⅲ. Nevertheless, the treatment with positive margin has to be further studied.

作者刘燕吴令英李斌黄婴马绍康袁光文

机构地区甘肃省人民医院中国医学科学院肿瘤医院

出处《实用妇产科杂志》 CAS CSCD 北大核心 2008年第4期235-237,共3页 Journal of Practical Obstetrics and Gynecology

关键词宫颈上皮内瘤变冷刀锥切术治疗 Cervical intraepithelial neoplesia Cold knife conization Treatment

分类号 R737.33 [医药卫生—肿瘤]

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