Zeng S Y, Liang M R, Li L Y, Wu Y Y
Department of Oncology, Maternal and Child Health Hospital of Jiangxi Province, Nanchang, China.
Eur J Gynaecol Oncol. 2012;33(3):257-60.
The aim of this was study to offer some reference for the treatment of cervical intraepithelial neoplasia (CIN) by comparing complication rates and treatment failure rates of different surgical methods of CIN.
1,256 cases of CIN diagnosed by punch biopsy and pathological confirmation of postoperative specimens between January 2002 and June 2007 were reviewed and analyzed, in which 74 cases underwent the loop electrosurgical excision procedure (LEEP), 869 patients adopted cold knife conization (CKC), 49 patients received vaginal enlarged amputation of cervix, and 264 patients accepted extrafascial hysterectomy. The chi-square test was used to compare the rate of complication and treatment failure of different surgical methods.
The rates of surgical complications for LEEP, CKC, vaginal enlarged amputation of the cervix and extrafascial hysterectomy were, respectively, 8.1% (6/74) 6.2% (54/869) 6.1% (3/49) and 2.3% (8/264), but this difference was not statistically significant. The treatment failure incidences for LEEP, CKC, vaginal enlarged amputation of cervix and external fascia hysterectomy were, respectively, 4.1% (3/74), 0.2% (2/869), 0.0% (0/49) and 0.4% (1/264). When comparing among the groups, the treatment failure incidence was higher in LEEP than that in CKC (p = 0.004) and extrafascial hysterectomy (p = 0.034); there was no statistically significant difference between CKC and extrafascial hysterectomy, and no significant difference was revealed between vaginal enlarged amputation of cervix and any other group.
LEEP, CKC, vaginal enlarged amputation of cervix and extrafascial hysterectomy are all secure and effective procedures for patients with CIN, and patients can make their own individual choice depending on different conditions.
本研究旨在通过比较不同手术方法治疗宫颈上皮内瘤变（CIN）的并发症发生率和治疗失败率，为CIN的治疗提供参考。
回顾性分析2002年1月至2007年6月间经活检钳取组织病理确诊为CIN的1256例患者，其中74例行宫颈环形电切术（LEEP），869例行冷刀锥切术（CKC），49例行阴道扩大宫颈切除术，264例行筋膜外子宫切除术。采用卡方检验比较不同手术方法的并发症发生率和治疗失败率。
LEEP、CKC、阴道扩大宫颈切除术和筋膜外子宫切除术的手术并发症发生率分别为8.1%（6/74）、6.2%（54/869）、6.1%（3/49）和2.3%（8/264），但差异无统计学意义。LEEP、CKC、阴道扩大宫颈切除术和筋膜外子宫切除术的治疗失败发生率分别为4.1%（3/74）、0.2%（2/869）、0.0%（0/49）和0.4%（1/264）。组间比较，LEEP的治疗失败发生率高于CKC（p = 0.004）和筋膜外子宫切除术（p = 0.034）；CKC与筋膜外子宫切除术之间差异无统计学意义，阴道扩大宫颈切除术与其他任何组之间也无显著差异。
LEEP、CKC、阴道扩大宫颈切除术和筋膜外子宫切除术对CIN患者均安全有效，患者可根据不同情况做出个体化选择。
