二次活检—宫颈锥切术在子宫颈病变诊治中的临床意义

发布时间：2018-03-26 01:42

本文选题：二次活检　切入点：宫颈锥切术　出处：《西安交通大学学报(医学版)》2017年01期

【摘要】：目的探讨二次活检—宫颈锥切术在子宫颈病变诊治中的临床价值及应用指征。方法选取济南军区总医院妇科2012.01-2015.10间行宫颈多点活检病理为子宫颈癌IA期及以下、采用宫颈环形电切(LEEP)术行宫颈锥切二次活检的413例患者的病例资料进行回顾性分析。结果与宫颈多点活检比较,约10.65%(44/413)锥切术后发生病理升级,73.37%(303/413)一致,15.98%(66/413)逆转(病理级别下降和转阴)。宫颈多点活检与二次活检—宫颈锥切术在诊断宫颈低级别上皮内病变、高级别上皮内病变、早期浸润癌(IA期)方面差异有统计学意义(T=21.740,v=3-1=2,P0.05)。锥切前高危型人乳头瘤病毒(HPV)感染的阳性率为71.91%(297/413);锥切后病理升级的高危型HPV感染阳性率为86.36%(38/44),未升级的为70.20%(259/369)。锥切前液基薄层细胞学(TCT)检查阳性(ASC-US及以上)为87.89%(363/413),其中11.85%(43/363)锥切后病理升级。对锥切后病理升级与未升级的宫颈病变的高危型HPV感染阳性率、TCT检测阳性率比较,差异均有统计学意义(χ2=5.092,P0.05;χ2=4.476,P0.05)。结论二次活检—宫颈锥切术作为宫颈多点活检术诊治宫颈病变的一种再评价,能显著提高确诊率,减少隐匿性宫颈癌的漏诊,但其在临床应用时有一定的指征。
[Abstract]:Objective to explore the clinical value and indication of double biopsis-cervix conization in the diagnosis and treatment of cervical lesions. Methods Cervical multipoint biopsy was performed in 10 gynecological departments of Jinan military region General Hospital from January 2012.0 to May 2015.The pathology of cervical cancer was IA stage and below. The data of 413 cases of cervical conical biopsy were analyzed retrospectively by means of circular electrosurgical excision of cervix (LEEP). The results were compared with that of multipoint cervical biopsy. About 10.65% 44 / 413) pathological upgrade occurred after conic resection: 73.37 / 303 / 413) 15.98% 66 / 413) reversal (pathological grade decline and negative change. Cervical multipoint biopsy and double biopsis-cervical conization in the diagnosis of cervical low grade intraepithelial lesions, high grade intraepithelial lesions, The positive rate of high risk HPV infection was 71.91 / 4130.The positive rate of high risk HPV infection was 86.366-38 / 444.The unupgraded rate was 70.20p / 3699.The positive rate of high risk HPV infection was 86.3640 / 38 / 44, and the positive rate of high risk HPV infection was 70.20p / 3690.The positive rate of high risk HPV infection was 71.91 / 4137.The positive rate of pathologically upgraded high-risk HPV infection was 86.3640 / 38 / 44, and the unupgraded rate was 70.20p / 3690.The positive rate of high risk type HPV infection was 70.20%. The positive rate of HPV infection was 87.89 / 413% (11.85% / 363). The positive rate of high risk HPV infection after conical resection was compared with that of non-upgraded cervical lesions. The difference was statistically significant (蠂 2 + 5.092 P 0.05; 蠂 2 + 4.476% P 0.05). Conclusion as a re-evaluation of cervical multipoint biopsy, the rate of diagnosis and treatment of occult cervical cancer can be significantly increased, and the missed diagnosis of occult cervical cancer can be reduced. But it has certain indication in clinical application.
【作者单位】：锦州医科大学济南军区总医院妇产科实习基地;济南军区总医院妇科;
【分类号】：R737.33

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