Academic Department of Obstetrics and Gynaecology, Colposcopy Unit, Royal Free Hospital, London, UK.
BJOG. 2010 Apr;117(5):615-9. doi: 10.1111/j.1471-0528.2010.02501.x. Epub 2010 Feb 15.
To compare two excisional treatments, laser cone biopsy and large loop excision of the transformation zone (LLETZ), in terms of the volume of tissue removed, and to determine the relation between the height and the total volume of the cone specimen.
Retrospective cross-sectional study.
Large teaching hospital in London.
A total of 1136 eligible excisional treatments (laser cone or large loop excision of the transformation zone, LLETZ).
Eligible excisional treatments (laser cone or LLETZ) performed between 1 January 2002 and 31 December 2007 in our colposcopy unit were identified using the Infoflex(R) database. The total volume of the cone biopsy was calculated mathematically using the data provided in the histopathology reports.
The volume of the cone biopsy was compared with the technique of excision and the histology grades.
Three hundred and thirty-nine laser cone biopsies were performed, whereas 797 LLETZ biopsies were recorded, during the study period. There was no difference in the mean age in the two groups. However, there is a proportional increase in the volume of the cone as the height of the cone increases, and a significant number of the values are skewed, suggesting that the diameter of the base of the cone contributes significantly to the total volume. Laser cone biopsies (median volume 1.84 cm(3), 95% CI 1.98-2.54 cm(3)) account for a larger volume of tissue excised compared with LLETZ (median volume 0.78 cm(3), 95% CI 0.91-1.02 cm(3)) (P < 0.0001). This relationship is not altered when the two procedures are stratified for grade of lesion, i.e. excision for low-grade cervical intraepithelial neoplasia (CIN) (laser median volume 1.55 cm(3), 95% CI 1.46-2.06; LLETZ median volume 0.62 cm(3), 95% CI 0.73-0.88 cm(3)) (P < 0.0001) or high-grade CIN (laser median volume 1.84 cm(3), 95% CI 2.11-2.53 cm(3); LLETZ median volume 0.82 cm(3), 95% CI 0.94-1.07 cm(3)) (P < 0.0001).
The volume of cervical tissue removed during laser conisation is significantly more than that removed with LLETZ. The indication of the cone biopsy does influence the volume of tissue removed.
比较两种切除治疗方法，即激光锥切术和大环形电切术（LLETZ），在切除组织量方面的差异，并确定锥切标本高度与总体积之间的关系。
回顾性横截面研究。
伦敦的一所大型教学医院。
共有 1136 例符合条件的切除术（激光锥切术或大环形电切术）。
使用 Infoflex(R) 数据库确定 2002 年 1 月 1 日至 2007 年 12 月 31 日期间在我们的阴道镜检查室进行的所有切除术（激光锥切术或 LLETZ）。使用组织病理学报告中提供的数据，通过数学方法计算出锥切标本的总体积。
比较锥切术和切除术技术以及组织学分级与锥切标本体积的关系。
研究期间共进行了 339 例激光锥切术，记录了 797 例 LLETZ 切除术。两组的平均年龄无差异。然而，随着锥高的增加，锥切标本的体积呈比例增加，并且大量值呈偏态分布，表明锥底的直径对总体积有显著影响。激光锥切术（中位数体积 1.84cm(3)，95%CI 1.98-2.54cm(3)）切除的组织量明显大于 LLETZ（中位数体积 0.78cm(3)，95%CI 0.91-1.02cm(3)）（P<0.0001）。当按病变分级对两种手术进行分层时，这种关系并未改变，即低级别宫颈上皮内瘤变（CIN）的切除（激光术中位数体积 1.55cm(3)，95%CI 1.46-2.06；LLETZ 中位数体积 0.62cm(3)，95%CI 0.73-0.88cm(3)）（P<0.0001）或高级别 CIN（激光术中位数体积 1.84cm(3)，95%CI 2.11-2.53cm(3)；LLETZ 中位数体积 0.82cm(3)，95%CI 0.94-1.07cm(3)）（P<0.0001）。
激光锥切术切除的宫颈组织量明显多于 LLETZ。锥切术的适应证确实会影响切除的组织量。
