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用于治疗重度宫颈上皮内瘤变(CIN)的打孔活检与环形活检的比较

Comparison of Punch Biopsy and Loop Biopsy for the Management of Severe Cervical Intraepithelial Neoplasia (CIN).

作者信息

Sahai Anjula, Bansal Vandana, Singh Priyanka

机构信息

Jeevan Jyoti Hospital, Allahabad, India.

Centre of Food Technology, University of Allahabad, Allahabad, India.

出版信息

J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):248-254. doi: 10.1007/s13224-021-01525-7. Epub 2021 Aug 6.

Abstract

OBJECTIVE

The study was undertaken for comparing the colposcopy directed punch versus loop excision biopsy technique in order to get the most précised sample for study as well as comparing the complications associated with them

MATERIALS AND METHODS

The prospective clinical study was conducted on 50 women of age group 20-80 years. Women who were found to have a Reid colposcopic index of high grade disease, low grade disease or invasive disease recognized as the patients needed biopsy. They were randomly divided into either the punch biopsy forceps group (PB group) or the round loop electrode group (LE group).

RESULT

The quality of tissue of the LE group was found significantly better than the tissue quality of PB group based on the size, site and tissue damaged measures. Both the groups were found to have the same cytology report as well as colposcopic diagnosis and histology reports. Mild degree of bleeding has been reported as a frequent complication in LEEP and punch biopsy. The VAS pain score associated in each procedure was found to be 2.4 and 2.8, respectively, in both groups with no significant difference.

CONCLUSION

The present study has concluded that the quality of tissue from the LEEP biopsy electrode was better than the punch biopsy forceps with no difference in the pain score, and it could be suggested that use of the round loop electrode in CDB provides good quality tissue to evaluate the histology.

摘要

目的

开展本研究以比较阴道镜引导下的咬取活检术与环形切除活检术,从而获取最精确的研究样本,并比较二者相关的并发症。

材料与方法

对50名年龄在20 - 80岁的女性进行前瞻性临床研究。被发现具有高级别病变、低级别病变或浸润性病变的Reid阴道镜指数的女性被认定为需要活检的患者。她们被随机分为咬取活检钳组(PB组)或环形电极组(LE组)。

结果

基于大小、部位和组织损伤程度的测量,发现LE组的组织质量明显优于PB组。两组的细胞学报告、阴道镜诊断和组织学报告均相同。据报道,轻度出血是leep手术和咬取活检中常见的并发症。两组中每个手术相关的视觉模拟评分(VAS)疼痛评分分别为2.4和2.8,无显著差异。

结论

本研究得出结论,leep活检电极获取的组织质量优于咬取活检钳,疼痛评分无差异,并且可以建议在宫颈疾病活检中使用环形电极可提供高质量组织用于评估组织学。

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本文引用的文献

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The use of colposcopic punch biopsy in the management of abnormal cervical cytology: a 5-year retrospective audit.
J Obstet Gynaecol. 2019 Jan;39(1):110-114. doi: 10.1080/01443615.2018.1468740. Epub 2018 Sep 19.
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Relevance of random biopsy at the transformation zone when colposcopy is negative.
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European guidelines for quality assurance in cervical histopathology.
Acta Oncol. 2011 Jun;50(5):611-20. doi: 10.3109/0284186X.2011.555779. Epub 2011 Feb 11.
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Eur Spine J. 2006 Jan;15 Suppl 1(Suppl 1):S17-24. doi: 10.1007/s00586-005-1044-x. Epub 2005 Dec 1.

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