不同术式治疗宫颈鳞状上皮病变临床病理研究

发布时间：2018-03-28 01:15

  本文选题：宫颈鳞状上皮内瘤变　切入点：宫颈锥切术　出处：《中华肿瘤防治杂志》2017年01期

【摘要】：目的宫颈癌筛查的普及极大地提高了宫颈癌前病变的检出率,而病理诊断对宫颈癌前病变的诊疗至关重要,癌前病变的精确病理分级对于宫颈癌前病变治疗效果的评价和治疗方法的选择具有重要意义。本研究旨在探讨宫颈鳞状上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅱ和Ⅲ级病变采用环形电切除术(loop electrosurgical excision procedure,LEEP)和宫颈冷刀锥切术(cold knife conization,CKC)前后,病理分级变化及其对CIN的诊断治疗作用。方法选择2015-01-01-2015-12-31在靖江市中医院就诊的经阴道镜多点活检病理确诊的CINⅡ和CINⅢ患者149例,随机数字表法分为LEEP组75例和CKC组74例,观察手术前后病理检查的符合度和病理降级、升级率。结果阴道镜多点活检与LEEP术后CIN病理符合率为56.00%(42/75),LEEP术后病理降级率为21.33%(16/75),病理升级率为22.67%(17/75)。阴道多点活检与CKC后CIN病理符合率为66.22%(49/74),病理升级率为12.16%(9/74),病理降级率为21.62%(16/74)。宫颈冷刀锥切术和LEEP术后病理与术前病理符合率、病理升级率、病理降级率比较差异均无统计学意义,P0.05;复发率差异无统计学意义,P0.05。结论 CINⅡ和CINⅢ级病变LEEP术和CKC术后病理结果无差异,具有相同的治愈率。建议根据临床及患者意愿选择治疗方法。
[Abstract]:Objective the prevalence of cervical cancer screening has greatly increased the detection rate of cervical precancerous lesions, and pathological diagnosis is very important to the diagnosis and treatment of cervical precancerous lesions. The accurate pathological grading of precancerous lesions is of great significance for the evaluation of the therapeutic effect and the choice of treatment methods for cervical precancerous lesions. This study was designed to investigate the use of ring ring in cervical squamous intraepithelial neoplasia (Cervical intraepithelial neoplasia cin) 鈪，

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