Department of Obstetrics and Gynaecology, Ioannina University Hospital, Ioannina, Greece.
Anticancer Res. 2012 Sep;32(9):4141-5.
To review the 22-year experience of the use of large loop excision of the transformation zone (LLETZ) for the treatment of cervical intraepithelial neoplasia (CIN).
Retrospective observational study.
University Hospital of Ioannina, Greece.
January 1989 until December 2011.
Women undergoing excisional treatment with LLETZ for CIN. Women with invasive disease were excluded.
Excisional treatment with LLETZ. Women had post-operative surveillance with cytology and colposcopy at 6, 12, 18 and 24 months, and yearly thereafter.
We assessed the histological outcomes and margin involvement, as well as the rate of treatment failures requiring a repeat conization.
A total of 3861 LLETZ biopsies were recorded during the study period. The histological evaluation of the cone specimens showed CIN1 in 897 (23.2%), CIN2 in 1129 (29.3%), CIN3 in 1322 (34.2%), microinvasive disease in 158 (4.1%), HPV lesions in 206 (5.3%) and normal histological findings in 149 (3.9%) women. The margins were reported as clear in 3166 (82%) cases, involved in 437 (11.3%) cases and uncertain in 258 (6.7%) cases. A total of 239 (6.2%) women underwent a second conization due to treatment failure.
LLETZ remains the most popular conservative technique of treatment for women with precancerous cervical lesions. Post-treatment surveillance of these women is essential in order to detect residual or recurrent disease. New HPV biomarkers, introduced over the last two years, appear to be useful in the follow-up after treatment. A scoring system may allow for accurate prediction of women at risk of treatment failure and for tailored post-treatment surveillance.
回顾 22 年来使用大圈切除术（LLETZ）治疗宫颈上皮内瘤变（CIN）的经验。
回顾性观察研究。
希腊约阿尼纳大学医院。
1989 年 1 月至 2011 年 12 月。
接受 LLETZ 治疗 CIN 的女性。排除患有侵袭性疾病的女性。
LLETZ 切除术。术后 6、12、18 和 24 个月及此后每年进行细胞学和阴道镜检查。
我们评估了组织学结果和边缘累及情况，以及需要重复锥切术治疗失败的发生率。
在研究期间共记录了 3861 例 LLETZ 活检。对锥切标本的组织学评估显示 CIN1 为 897 例（23.2%），CIN2 为 1129 例（29.3%），CIN3 为 1322 例（34.2%），微侵袭性疾病为 158 例（4.1%），HPV 病变为 206 例（5.3%），正常组织学发现为 149 例（3.9%）。边缘报告为无累及的有 3166 例（82%），累及的有 437 例（11.3%），不确定的有 258 例（6.7%）。共有 239 例（6.2%）女性因治疗失败而再次行锥切术。
LLETZ 仍然是治疗宫颈癌前病变妇女最受欢迎的保守治疗技术。对这些女性进行治疗后随访至关重要，以便发现残留或复发疾病。过去两年引入的新 HPV 生物标志物似乎在治疗后随访中有用。评分系统可能有助于准确预测治疗失败风险高的女性，并为量身定制的治疗后监测提供依据。
