阴道镜活检联合子宫颈环形电刀在宫颈微小浸润癌患者中的应用效果

发布时间：2018-01-30 22:16

  本文关键词： 阴道镜活检 LEEP刀 宫颈微小浸润癌 诊断　出处：《中国内镜杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探究阴道镜活检联合子宫颈环形电刀(LEEP刀)锥切术在宫颈微小浸润癌患者中的应用效果。方法回顾性分析2013年6月-2016年6月该院经LEEP锥切术诊断为微小浸润癌的66例患者的临床资料。术前66例患者均经阴道镜活检,比较阴道镜活检与LEEP锥切术对微小浸润癌诊断的情况,不同间质浸润深度和切缘情况患者LEEP锥切术后病变残留情况。结果阴道镜活检检出2例轻度鳞状细胞上皮内瘤变(LSIL)、60例重度鳞状上皮内瘤变(HSIL)、1例宫颈原位腺癌(AIS),3例患者诊断为子宫颈微小浸润癌或可疑子宫颈微小浸润癌,敏感度为4.54%,漏诊率为95.46%;LEEP锥切术检出1例LSIL、44例HSIL、1例AIS,20例切缘阴性。3组患者LEEP锥切术切除组织的厚度和面积差异无统计学意义(P0.05)。微小浸润癌组患者切除组织的深度明显高于HSIL及AIS组,HSIL及AIS组患者切除组织的深度高于LSIL组,差异具有统计学意义(P0.05)。间质浸润深度≤1 mm组、1 mm间质浸润深度≤3 mm组和3 mm间质浸润深度≤5 mm组患者的术后病变残留率分别为15.00%、19.51%和20.00%,差异无统计学意义(P0.05)。内切缘阳性组、外切缘阳性组和纤维间质切缘阳性组患者的术后病变残留率分别为25.00%、15.38%和23.80%,差异无统计学意义(P0.05)。结论单纯阴道镜活检诊断子宫颈微小浸润癌漏诊率较高,联合LEEP锥切术诊断能够提高诊断率。
[Abstract]:Objective to explore the combination of colposcopy biopsy and cervix ring electric knife (LEEP). Clinical data of 66 patients with microinvasive carcinoma of the cervix diagnosed by LEEP conization from June 2013 to June 2016 were retrospectively analyzed. Materials. All the 66 patients underwent colposcopy biopsy before operation. To compare the diagnosis of microinvasive carcinoma with colposcopy biopsy and LEEP conization. Results 2 cases of mild squamous cell intraepithelial neoplasia were detected by colposcopy biopsy. 60 cases of severe squamous intraepithelial neoplasia (HSILN) and 1 case of in situ adenocarcinoma of cervix were diagnosed as small invasive carcinoma of the cervix or suspected small invasive carcinoma of the cervix with a sensitivity of 4.54%. The missed diagnosis rate was 95.46; One case of LSILA was detected by LEEP conization in 44 cases with HSILA and 1 case with AIS. There was no significant difference in the thickness and area of tissue resected by LEEP conization in 20 patients with negative margin (P 0.05). The depth of resected tissue in patients with microinvasive carcinoma was significantly higher than that in HSIL and AIS groups. The depth of resected tissue in HSIL and AIS group was higher than that in LSIL group, the difference was statistically significant (P 0.05). The interstitial infiltration depth 鈮，

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