Temkin Sarah M, Hellmann Mira, Lee Yi-Chun, Abulafia Ovadia
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, State University of New York Downstate Medical Center, Brooklyn, NY 11203, USA.
Am J Obstet Gynecol. 2007 May;196(5):469.e1-4. doi: 10.1016/j.ajog.2006.11.018.
To identify parameters associated with the presence or development of invasive cervical cancer among patients who underwent cold knife conization (CKC) following loop electrocautery excision procedure (LEEP) revealing positive endocervical curettings for stage 3 cervical intraepithelial neoplasia (CIN III).
Patients who underwent CKC following LEEP with endocervical curettings indicating CIN III were observed retrospectively.
Of 146 patients identified, 133 (91.1%) had residual CIN on their cone biopsy; 23 (15.8%) had invasive cervical carcinoma. Patients with residual CIN III, ectocervical and endocervical margins with CIN, and positive endocervical curettings on cone biopsy were more likely to harbor or develop invasive cervical carcinoma.
Patients with CIN III on endocervical curettage at the time of LEEP procedure are at high risk for harboring residual cervical dysplasia or micros-invasive carcinoma, or developing carcinoma in the future. Residual CIN III, ectocervical or endocervical margins positive for CIN, and/or positive endocervical curettings on CKC subsequent to LEEP with positive endocervical curettings for CIN III all indicate a higher likelihood of harboring or developing cervical carcinoma.
在宫颈环形电切术(LEEP)后宫颈管刮术结果显示为3级宫颈上皮内瘤变(CIN III)阳性的患者中,确定与浸润性宫颈癌的存在或发展相关的参数。
对LEEP术后接受宫颈冷刀锥切术(CKC)且宫颈管刮术提示CIN III的患者进行回顾性观察。
在146例确诊患者中,133例(91.1%)在锥切活检时有残留CIN;23例(15.8%)患有浸润性宫颈癌。锥切活检有残留CIN III、宫颈外口和宫颈管切缘有CIN以及宫颈管刮术阳性的患者更有可能患有或发展为浸润性宫颈癌。
LEEP手术时宫颈管刮术为CIN III的患者有残留宫颈发育异常或微浸润癌,或未来发生癌变的高风险。LEEP术后CKC时残留CIN III、宫颈外口或宫颈管切缘CIN阳性和/或宫颈管刮术阳性,均提示患有或发展为宫颈癌的可能性更高。