微型阴道镜检查能否保护患有宫颈上皮内瘤变（CIN）且阴道镜检查结果不理想的患者，使其在锥形切除时避免疾病切除不完全的风险？
Does microcolposcopy protect patients with CIN and unsatisfactory colposcopy from the risk of incomplete excision of disease at the time of conization?
作者信息
Costa Silvano, De Simone Pia, De Nuzzo Maria, Terzano Patrizia, Santini Donatella, Cristiani Paolo, Bovicelli Alessandro, Infante Fanny E, Bucchi Lauro
机构信息
Department of Obstetrics and Gynecology, University of Bologna, Bologna, Italy.
出版信息
J Low Genit Tract Dis. 2002 Jan;6(1):5-10. doi: 10.1046/j.1526-0976.2002.61002.x.
OBJECTIVE
To evaluate the effectiveness of microcolposcopy in preventing incomplete electrosurgical excision at the endocervical cone margin in patients with CIN and unsatisfactory colposcopy.
MATERIALS AND METHODS
Four-hundred and twenty-one patients were studied. Complete excision of disease at the endocervical margin was evaluated using multiple logistic regression analysis.
RESULTS
One-hundred and eighty-three patients underwent microcolposcopy. In 160 patients, the cone depth exceeded the endocervical extension of the squamocolumnar junction as predicted by microcolposcopy. In 23 patients, the opposite was observed. Microcolposcopy was not performed in 238 patients. For the three groups, the frequency of endocervical cone margin involvement was 22%, 22%, and 13%, respectively. Multiple logistic regression analysis showed that patients with a cone depth exceeding the endocervical margin of the squamocolumnar junction as predicted by microcolposcopy had no reduction in the risk of incomplete conization.
CONCLUSION
The use of microcolposcopy awaits validation for assessment of the transformation zone to predict negative conization margins.
目的
评估微型阴道镜检查在预防宫颈上皮内瘤变（CIN）且阴道镜检查结果不理想的患者宫颈锥切缘电外科切除不完全方面的有效性。
材料与方法
对421例患者进行了研究。使用多因素逻辑回归分析评估宫颈内缘疾病的完全切除情况。
结果
183例患者接受了微型阴道镜检查。在160例患者中，宫颈锥切深度超过了微型阴道镜检查预测的鳞柱交界的宫颈内延伸范围。在23例患者中，观察到相反的情况。238例患者未进行微型阴道镜检查。对于这三组，宫颈锥切缘受累的频率分别为22%、22%和13%。多因素逻辑回归分析表明，宫颈锥切深度超过微型阴道镜检查预测的鳞柱交界宫颈内缘的患者，锥切不完全的风险没有降低。
结论
微型阴道镜检查在评估转化区以预测锥切阴性切缘方面的有效性有待验证。
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