DeSimone Christopher P, Day Misty E, Dietrich Charles S, Tovar Molly M, Modesitt Susan C
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Kentucky Markey Cancer Center, 333 Whitney-Hendrickson Building, 800 Rose Street, Lexington, KY 40536-0298, USA.
J Reprod Med. 2011 Sep-Oct;56(9-10):376-80.
To evaluate the risk for residual adenocarcinoma in situ (AIS) or cervical adenocarcinoma in women undergoing loop electrosurgical excision procedure (LEEP)/conization as the initial management for AIS.
A retrospective chart study was conducted from 1990 to 2005. Patients with AIS were identified from a pathology database.
Forty-three patients were identified with AIS of the cervix who were initially treated with LEEP/conization. Twelve cases of invasive adenocarcinoma (28%) were identified on LEEP/conization. Margin status was available for 41 patients. Twenty (49%) patients had a positive margin, and 21 (51%) patients had a negative margin. Nineteen women with positive margins underwent definitive surgical therapy; 68% had residual AIS. Eleven women with negative margins underwent hysterectomy; 45% had residual AIS. Women with positive and negative margins were compared and found to differ significantly in regard to diagnosis of adenocarcinoma on LEEP/conization.
Women status post-LEEP/conization for AIS have a high risk of residual AIS, even with negative conization margins. If definitive hysterectomy is deferred, close follow-up is mandatory.
评估接受环形电切术（LEEP）/锥形切除术作为原位腺癌（AIS）初始治疗的女性残留原位腺癌或宫颈腺癌的风险。
进行了一项1990年至2005年的回顾性图表研究。从病理数据库中识别出AIS患者。
确定43例宫颈AIS患者最初接受了LEEP/锥形切除术治疗。在LEEP/锥形切除术中发现12例浸润性腺癌（28%）。41例患者的切缘状态可用。20例（49%）患者切缘阳性，21例（51%）患者切缘阴性。19例切缘阳性的女性接受了确定性手术治疗；68%有残留AIS。11例切缘阴性的女性接受了子宫切除术；45%有残留AIS。对切缘阳性和阴性的女性进行比较，发现她们在LEEP/锥形切除术中腺癌诊断方面有显著差异。
AIS接受LEEP/锥形切除术后的女性即使切缘阴性也有很高的残留AIS风险。如果推迟进行确定性子宫切除术，则必须密切随访。
