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[接触式钕钇铝石榴石激光治疗子宫颈发育异常和早期癌的临床评估]

[Clinical evaluation of contact Nd.YAG laser therapy of dysplasia and early cancer of the uterine cervix].

作者信息

Ueki M, Kitsuki K

机构信息

Department of Obstetrics and Gynecology, Osaka Medical School.

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1988 Dec;40(12):1826-32.

PMID:3209910
Abstract

For the past four years, cone and cone with cautery have been carried out by the contact Nd.YAG laser method after diagnosis with colpo.cervicoscopy in 174 cases of dysplasia and early cancer of the uterine cervix. The subjects were 82 patients with dysplasia, 75 patients with carcinoma in situ and 17 patients with microinvasive carcinoma. The cure rate based on the follow up for 6 to 50 months was 97.7%. There were 7 (4.1%) residual cases, 6 with residual mild dysplasia that required a follow up. Three cases with mild dysplasia disappeared during a follow up. In the remaining case, a semiradical hysterectomy was performed owing to Ib"occ" (8mm). Postoperative histological findings confirmed 76.2% of the preoperative findings; the rate of underdiagnosis was 23.8%. The rates of incomplete excision and underdiagnosis decreased in the cases where preoperative biopsy findings agreed with or overestimated cytologic and colpo.cervicoscopic findings. The results suggest that the laser cone is very useful as conservative therapy for early cervical neoplasia, and the cone specimen can be used to evaluate the success of the therapy and to improve future preoperative diagnosis.

摘要

在过去四年中,对174例子宫颈发育异常和早期癌患者,在经阴道宫颈镜检查确诊后,采用接触式Nd.YAG激光法进行了锥形切除术及锥形切除加电灼术。研究对象包括82例发育异常患者、75例原位癌患者和17例微浸润癌患者。基于6至50个月的随访,治愈率为97.7%。有7例(4.1%)残留病例,其中6例残留轻度发育异常,需要随访。3例轻度发育异常在随访期间消失。在其余病例中,因Ib"occ"(8mm)行次广泛子宫切除术。术后组织学检查结果证实了76.2%的术前诊断结果;漏诊率为23.8%。术前活检结果与细胞学及阴道宫颈镜检查结果相符或高估时,不完全切除率和漏诊率降低。结果表明,激光锥形切除术作为早期宫颈肿瘤的保守治疗方法非常有用,锥形切除标本可用于评估治疗效果并改善未来的术前诊断。

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