van Nagell J R, Parker J C, Hicks L P, Conrad R, England G
Am J Obstet Gynecol. 1976 Jan 15;124(2):134-9. doi: 10.1016/s0002-9378(16)33288-4.
Cervical conization was perfromed on 756 patients at the University of Kentucky Medical Center from July 1, 1964, to January 1, 1973. Sixty-six patients were pregnant at the time of conization. Eighty-six per cent of patients with cytologic findings of carcinoma in situ had histologic verification of carcinoma in situ or severe dysplasia, and there was absolute correlation between cytology and histology in 75 per cent of patients will occult invasive cancer. Cervical biopsies without colposcopic direction predicted either severe dysplasia or carcinoma in situ in 77 per cent of cases but were accurate in only seven of 24 patients with occult invasive cancer. Carcinoma in situ was present in 30 per cent of hysterectomy specimens following conization but recurred in only seven per cent of patients followed without hysterectomy. Recurrent carcinoma in situ following hysterectomy was more common in patients with residual intraepithelial cancer in the uterus but was independent of the size of the vaginal cuff removed. Major postconization complications requiring hospitalization occurred in 3.4 per cent of nonpregnant patients and in 7.5 per cent of pregnant patients.
1964年7月1日至1973年1月1日期间，肯塔基大学医学中心对756例患者实施了宫颈锥切术。其中66例患者在锥切术时已怀孕。细胞学检查结果为原位癌的患者中，86%经组织学检查证实为原位癌或重度发育异常；在75%隐匿性浸润癌患者中，细胞学和组织学结果完全相符。未在阴道镜引导下进行的宫颈活检在77%的病例中可预测重度发育异常或原位癌，但在24例隐匿性浸润癌患者中仅7例诊断准确。锥切术后子宫切除标本中30%存在原位癌，但未行子宫切除的患者中仅7%原位癌复发。子宫切除术后原位癌复发在子宫内残留上皮内癌的患者中更为常见，但与切除的阴道残端大小无关。非妊娠患者中3.4%、妊娠患者中7.5%出现需要住院治疗的主要锥切术后并发症。
