环形电切术切缘阳性的高级别鳞状上皮内病变患者的肿瘤持续存在情况。

Tumor persistence in high grade squamous intraepithelial lesion patients with positive surgical margin post loop electrosurgical excision procedure.

作者信息

Sankasem Arunee, Thavaramara Thaovalai, Manusirivithaya Sumonmal, Tangjitgamol Siriwan

机构信息

Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Thailand.

出版信息

J Med Assoc Thai. 2006 Jul;89(7):934-40.

PMID:16881423

Abstract

OBJECTIVE

To determine the rates of persistent and recurrent tumors in patients with High Grade Squamous Intraepithelial Lesion (HSIL) who had positive surgical margin from Loop Electrosurgical Excision Procedure (LEEP).

MATERIAL AND METHOD

Clinical and pathological data of all women who underwent LEEP procedures and revealed HSIL lesions with positive surgical margin between July 1997 and December 2004 were recorded.

RESULTS

Histologic diagnoses of HSIL with positive surgical margin were found in 95 cases during the study period. Residual diseases were identified at ectocervical margins in 46 cases (48.4%), endocervical margin in 26 cases (27.4%), and both margins in 23 cases (24.2%). Subsequent hysterectomy was performed in 58 cases (61.0%). The remaining 37 cases (38.9%) underwent periodic follow-up with the median follow up period of 11 months (range, 1-74 months). Persistent diseases were identified in 18 of 58 hysterectomized cases but none in 37 follow-up cases. Recurrent disease was identified in only one case in the follow-up group. Overall the rates of persistent and recurrent disease were found in 18.9% and 1.1% respectively.

CONCLUSION

In HSIL patients with positive surgical margin from LEEP the rate of persistent disease was 18.9%, while the rate of recurrence was 1.1%.

摘要

目的

确定接受环形电切术（LEEP）后手术切缘阳性的高级别鳞状上皮内病变（HSIL）患者中持续性肿瘤和复发性肿瘤的发生率。

材料与方法

记录1997年7月至2004年12月期间所有接受LEEP手术且手术切缘阳性的HSIL病变女性的临床和病理数据。

结果

在研究期间，95例患者的组织学诊断为手术切缘阳性的HSIL。46例（48.4%）患者的宫颈外口切缘有残留病变，26例（27.4%）患者的宫颈内口切缘有残留病变，23例（24.2%）患者的双侧切缘均有残留病变。58例（61.0%）患者随后接受了子宫切除术。其余37例（38.9%）患者接受定期随访，中位随访期为11个月（范围1 - 74个月）。58例接受子宫切除术的患者中有18例发现持续性病变，但37例随访患者中均未发现。随访组仅1例发现复发性病变。总体而言，持续性疾病和复发性疾病的发生率分别为18.9%和1.1%。