宫颈锥切术在诊断宫颈病变中的价值分析

摘要

目的:探讨宫颈锥切术能否被阴道镜多点活检所代替以及宫颈锥切术在诊断宫颈上皮内瘤样病变(CIN) 和早期宫颈癌中的价值.方法:回顾分析2007年1月-12月在江西省妇幼保健院肿瘤科因宫颈病变同时行阴道镜多点活检和宫颈锥切术(包括冷刀和电圈环切术即LEEP术)的患者120例,采用自身对照法,研究宫颈锥切术和阴道镜多点活检的病检结果的差异.结果:宫颈锥切术与阴道镜下多点活检病理符合者59例(49.17%);不符合者61例(50.83 %),宫颈锥切术后病理诊断加重者35例(占29.17%),浸润癌漏诊率10.00 %.结论:宫颈锥切术在诊断CIN 和早期宫颈癌中具有重要价值,不能被阴道镜多点活检所取代.要重视切缘是否阳性并加强术后随访.%Objective: To determine whether cervical conization can be instead of colposcopic multiple biopsies and to evaluate the clinical value of cervical conization in diagnosis of cervical intraepithelial neoplasia ( CIN ) and early cervical cancer.Methods :All 120 patients with CIN underwent cervical conization by leep ring resection or cold knife conization of cervix were retrospectively compared to pathology between cervical conization and colposcopic multiple biopsies.Results: Of the 120 patients, there was a correlarion in pathology cervical conization and colposcopic multiple biopsies in 59 cases (49.17％), but there was no much correspondence between cervical conization and colposcopic multiple biopsies in 61 cases ( 50.83％ ).The pathological grade of ultimate diagnosis after cervical conization increased in 35 cases( 29.17％ ).The rate of missed diagnosis in invasive cancer was 10.00 ％.Conclusion:Cervical conization plays a very important role in diagnosis of CIN and early cervical cancer.It can not instead of colposcopic multiple biopsies.We should follow up closely and offer further treatment properly to the cases with positive margin.