Kraus H, Schuhmann R, Breinl H, Piroth H
Geburtshilfe Frauenheilkd. 1976 May;36(5):439-44.
In cone biopsies of 413 patients we found 394 cases with premalignant or malignant lesions of squamous epithelium. Judged by the examination of the margins of the cone biopsy specimens, the removal of these epithelial lesions was found to be complete in an average of 62,9%. The increasing degree of epithelial atypia correlated with an increasing rate of residual malignant or premalignant tissue. The operation was mostly not radical in the endocervix. In 154 cases subsequent hysterectomia was performed. In 22% of the cases in which the margins of the cone biopsy specimens were free of epithelial changes, residual atypia was discovered in the uterus. On the contrary, in 35% of patients in which residual epithelial atypia was suspected, the uterus was found to be free of malignancy. The reasons are discussed. It is emphasized to pay attention to radical excision especially in the endocervix. Follow-up and smear controls are also necessary when margins of cone biopsy specimen are free of epithelial atypia. In young females desiring further pregnancies, treatment can be left at conisation even if it was not radical; frequent smear controls are obligatory in these cases.
在对413例患者进行的宫颈锥形切除术中,我们发现394例存在鳞状上皮的癌前或恶性病变。通过对宫颈锥形切除标本边缘的检查判断,发现这些上皮病变的切除平均完成率为62.9%。上皮异型程度的增加与残余恶性或癌前组织的比例增加相关。该手术在内宫颈处大多不彻底。154例患者随后进行了子宫切除术。在宫颈锥形切除标本边缘无上皮改变的病例中,22%在子宫中发现了残余异型性。相反,在怀疑有残余上皮异型性的患者中,35%的子宫未发现恶性病变。对原因进行了讨论。强调尤其在内宫颈处要注意根治性切除。当宫颈锥形切除标本边缘无上皮异型性时,随访和涂片检查也是必要的。对于希望进一步怀孕的年轻女性,即使手术不彻底,也可仅进行锥形切除术;在这些病例中必须频繁进行涂片检查。