First Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, Athens, Greece.
In Vivo. 2011 Jul-Aug;25(4):691-5.
To investigate the oncologically safe limits of excision in large loop excision of the transformation zone (LLETZ) conisation performed for cervical pathology.
A retrospective study conducted at the Colposcopy Unit in a University Hospital setting. Three hundred and sixty-one cases of LLETZ conisation were conducted in a 2-year period. Data concerning age, cone dimensions, lesion types and excision margins were recorded.
The mean age of women was 36.7 years, with 181 (50.5%) low-grade squamous intraepithelial lesion cases, 166 (45.7%) high-grade squamous intraepithelial lesion, and 14 (3.8%) with stage-IA1 cervical carcinoma. Mean conisation depth and cone volume were 10.9 mm and 2.2 ml, respectively. Incomplete removal of lesions occurred in 25% of women and correlated to severity of cervical intraepithelial neoplasia and conisation depth. The higher the grade of the lesion, the greater the percentage of residual disease. Conisation depth exceeding 10 mm, in our cohort, led to significantly less residual disease.
Results indicate that a conisation depth of <10 mm may be a risk factor predicting positive resection margins, while cone volume is an inappropriate clinical marker.
探讨宫颈病变行大环形电切术（LLETZ）锥切时切除的肿瘤学安全范围。
这是在一所大学医院的阴道镜检查室进行的回顾性研究。在 2 年期间进行了 361 例 LLETZ 锥切。记录了有关年龄、锥高、病变类型和切除边缘的数据。
女性的平均年龄为 36.7 岁，其中 181 例（50.5%）为低级别鳞状上皮内病变，166 例（45.7%）为高级别鳞状上皮内病变，14 例（3.8%）为 IA1 期宫颈癌。平均锥切深度和锥高分别为 10.9mm 和 2.2ml。25%的女性存在病变切除不完全，与宫颈上皮内瘤变严重程度和锥切深度相关。病变程度越高，残留疾病的比例越大。在本队列中，锥切深度超过 10mm 与显著减少残留疾病相关。
结果表明，锥切深度<10mm 可能是预测阳性切缘的危险因素，而锥高是一个不合适的临床标志物。
