在排除钳取活检的方案中，采用电外科环形切除术/锥切术治疗宫颈上皮内瘤变——一项210例病例的研究

Electrosurgical loop excision/conisation for cervical intraepithelial neoplasia in an algorithm that excludes punch biopsy--a study of 210 cases.

作者信息

Socolov D, Anton G, Anton A C, Anton E, Socolov R V, Teleman S, Melinte A, Boiculese L, Stoian M

机构信息

Department Obstetrics and Gynecology, University of Medicine and Pharmacy "Gr.T. Popa", Iasi, Romania.

出版信息

Chirurgia (Bucur). 2009 May-Jun;104(3):295-301.

PMID:19601461

Abstract

UNLABELLED

This study aims to evaluate the use of LLETZ/conisation in an algorithm that excludes the colposcopically guided biopsy.

MATERIAL AND METHODS

The study was carried out on 210 patients with LLETZ/conisation, performed in our service in 2 years. They were selected by pap smear, colposcopy, HPV genotyping, without punch biopsy.

RESULTS

The pathological results on the excision specimen showed: benign lesion 10%, CIN 1/condyloma 58%, CIN 2 18%, CIN 3/CIS 11%, microinvasion 2% and invasion 1%. The Pap test showed: HGSIL 27%, LGSIL 56%, ASCUS 13%, and normal/benign in 4%. The therapeutic efficiency of the excisional treatment showed that there was a 9.5% excessive treatment, 14.8 residual lesions, 3 cases of hemorrhage, 2 cervical stenosis, and 7 cases with specimen alteration that made the pathological diagnostic difficult or impossible. In conclusion, the LLETZ/conisation are ambulatory procedures with an acceptable rate of over-treatment and residual lesions, and reduced rate of complication.

摘要

未标记

本研究旨在评估在一种不包括阴道镜引导下活检的算法中使用大环状电切除术/锥形切除术的情况。

材料与方法

该研究对210例行大环状电切除术/锥形切除术的患者进行，这些手术在我们科室2年内完成。他们通过巴氏涂片、阴道镜检查、HPV基因分型进行选择，未进行穿刺活检。

结果

切除标本的病理结果显示：良性病变10%，CIN 1/尖锐湿疣58%，CIN 2 18%，CIN 3/CIS 11%，微浸润2%，浸润1%。巴氏试验显示：高度鳞状上皮内病变27%，低度鳞状上皮内病变56%，非典型鳞状细胞不能明确意义13%，正常/良性4%。切除治疗的疗效显示，过度治疗率为9.5%，残留病变率为14.8%，3例出血，2例宫颈狭窄，7例标本改变导致病理诊断困难或无法诊断。总之，大环状电切除术/锥形切除术是门诊手术，过度治疗和残留病变率可接受，并发症发生率降低。