Myllynen L, Karjalainen O
Ann Chir Gynaecol. 1984;73(1):45-9.
520 patients with a preoperative diagnosis of cervical intraepithelial neoplasia (CIN) were operated. The diagnoses obtained by colposcopically directed biopsy and endocervical curettage were compared with those obtained by cone biopsy or/and hysterectomy. Underdiagnosis occurred in 18.9% of the cases, if severe dysplasia and carcinoma in situ were considered to be separate conditions. When these two diagnoses were combined as CIN 3 the underdiagnosis rate declined to 11.0%. CIN 3 changed to invasive carcinoma in 1.5% and to microinvasive carcinoma in 4.4% of the cases. The preoperative diagnosis of CIN seems not to be accurate enough to make cone biopsy totally unnecessary as a complementary diagnostic step.
520例术前诊断为宫颈上皮内瘤变（CIN）的患者接受了手术。将阴道镜引导下活检和宫颈管刮除术所获得的诊断结果与锥形活检或/和子宫切除术所获得的诊断结果进行了比较。如果将重度发育异常和原位癌视为不同情况，漏诊率为18.9%。当这两种诊断合并为CIN 3时，漏诊率降至11.0%。在1.5%的病例中，CIN 3转变为浸润癌，在4.4%的病例中转变为微浸润癌。术前对CIN的诊断似乎不够准确，以至于不能完全不需要锥形活检作为补充诊断步骤。
