Lee Shin Wha, Kim Yong-Man, Son Woo-Seok, You Hang-Jo, Kim Dae-Yeon, Kim Jong-Hyeok, Kim Young-Tak, Nam Joo-Hyun
Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea.
Acta Obstet Gynecol Scand. 2009;88(2):209-15. doi: 10.1080/00016340802596009.
To investigate the efficacy of conization followed by conservative management for treating stage IA1 microinvasive carcinoma of the uterine cervix.
DESIGN/SETTING: Retrospective study.
Seventy-five patients treated for stage IA1 microinvasive carcinoma of the cervix. Patients underwent conization followed by hysterectomy (Group 1, 53 patients), or were followed by conservative management (Group 2, 22 patients).
Medical and histopathological record review.
For Group 1, pathology results showed that 30 had no residual tumor, one had cervical intraepithelial neoplasia (CIN) I, 11 had CIN III/cervical carcinoma in situ (CIS), nine had microinvasive carcinomas, and one had an invasive carcinoma (outcome for one patient not recorded). For Group 2, secondary procedures involved only cervical smears for 12 (48%) patients, of whom nine had normal cytology, one had low-grade squamous intraepithelial lesion and two had high-grade squamous intraepithelial lesions. For 13 (52%) patients in Group 2, secondary procedures involved repeat conization on whom six had no residual tumor, one had CIN II, four CIN III/CIS, and two microinvasive carcinoma and a negative resection margin. Therefore, conization followed by conservative management was an effective treatment for 90.9% (20/22) of Group 2. In neither group was recurrence recorded. There was no relation between lymphovascular invasion and follow-up cytology or pathology results, or between resection margin status and follow-up examination results.
Conization alone with careful follow-up appears to be an effective and safe treatment for patients with stage IA1 microinvasive carcinoma of the uterine cervix, regardless of resection margins status or lymphovascular invasion.
探讨宫颈锥切术联合保守治疗对IA1期宫颈微浸润癌的疗效。
设计/地点：回顾性研究。
75例接受IA1期宫颈微浸润癌治疗的患者。患者接受宫颈锥切术加子宫切除术（第1组，53例患者），或接受保守治疗（第2组，22例患者）。
回顾医疗和组织病理学记录。
第1组病理结果显示，30例无残留肿瘤，1例有宫颈上皮内瘤变（CIN）I级，11例有CIN III级/宫颈原位癌（CIS），9例有微浸润癌，1例有浸润癌（1例患者的结果未记录）。第2组中，12例（48%）患者的二次手术仅包括宫颈涂片，其中9例细胞学正常，1例有低级别鳞状上皮内病变，2例有高级别鳞状上皮内病变。第2组中13例（52%）患者的二次手术包括再次锥切术，其中6例无残留肿瘤，1例有CIN II级，4例有CIN III级/CIS，2例有微浸润癌且切缘阴性。因此，宫颈锥切术联合保守治疗对第2组90.9%（20/22）的患者有效。两组均未记录到复发情况。脉管浸润与随访细胞学或病理结果之间，以及切缘状态与随访检查结果之间均无关联。
对于IA1期宫颈微浸润癌患者，无论切缘状态或脉管浸润情况如何，单纯宫颈锥切术并仔细随访似乎是一种有效且安全的治疗方法。
