Mandic Aljosa, Knezevic-Usaj Slavica, Nincic Dejan, Rajovic Jelka, Popovic Marina, Kapicl Tatjana Ivkovic
Oncology Institute of Vojvodina, Sremska Kamenica, Serbia.
Acta Medica (Hradec Kralove). 2013;56(1):19-22. doi: 10.14712/18059694.2014.33.
A definitive diagnosis of cervical intraepithelial neoplasia (CIN) is confirmed after histopathological (HP) examination of the tissue obtained through the biopsy. The aim of this study was to compare histopathological results obtained with punch biopsy and results obtained through one of the excisional techniques.
We analysed histology results of 130 patients referred to our institution with abnormal smear. Punch biopsy was performed after colposcopic examination in all patients before one of the excision methods. Excision methods performed were: large loop excision of transformation zone (LLETZ), radio-frequency knife conisation or cold knife conisation. Based on the histopathological examination of the punch biopsy specimen or excisional specimen diagnosis of CIN was established.
CIN and invasive cancer were the most common diagnoses in the 31-40 age group at 45.4% (59/130). Discrepancies in the histological diagnosis between punch biopsy and excisional biopsy was identified in 58.5% (76/130) of the patients. In 6% of the of the cases the biopsy did not detect an invasive carcinoma.
The most frequent discrepancies between punch biopsy and excisional biopsy were in the group of patients with a higher grade cervical dysplasia. Mild dysplastic changes diagnosed through punch biopsy, require a more conservative approach, as the majority of this group had negative specimens on the cone after excision, especially in the younger population. It is advisable that the patients above 30 years of age and a higher grade dysplasia in the biopsy specimen, should undergo one of the excisional techniques as a diagnostic/therapeutic method of treatment.
通过活检获取组织进行组织病理学（HP）检查后，方可确诊宫颈上皮内瘤变（CIN）。本研究旨在比较穿刺活检与其中一种切除技术所获得的组织病理学结果。
我们分析了130例因涂片异常转诊至我院患者的组织学结果。所有患者在采用其中一种切除方法之前，均先在阴道镜检查后进行穿刺活检。所采用的切除方法包括：转化区大环形切除术（LLETZ）、射频刀锥切术或冷刀锥切术。根据穿刺活检标本或切除标本的组织病理学检查结果确诊CIN。
在31 - 40岁年龄组中，CIN和浸润癌是最常见的诊断结果，占45.4%（59/130）。58.5%（76/130）的患者在穿刺活检和切除活检的组织学诊断上存在差异。在6%的病例中，活检未检测到浸润癌。
穿刺活检与切除活检之间最常见的差异出现在宫颈发育异常程度较高的患者组中。通过穿刺活检诊断为轻度发育异常改变的患者，需要采取更保守的方法，因为该组大多数患者切除术后的锥形标本结果为阴性，尤其是在年轻人群中。建议年龄在30岁以上且活检标本中发育异常程度较高的患者，应采用其中一种切除技术作为诊断/治疗方法。
