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宫颈上皮内瘤变的诊断与治疗观点。对锥切组织的10年随访

Diagnostic and therapeutic viewpoints on cervical intraepithelial neoplasia. 10-Year follow-up of a conization material.

作者信息

Andersch B, Moinian M

出版信息

Gynecol Obstet Invest. 1982;13(4):193-205. doi: 10.1159/000299517.

Abstract

In 429 women with the diagnosis of cancer in situ (CIS), we found, during a follow-up time of 10 years, a relapse frequency of 5.3%; conization was the primary treatment in 414 cases, in 13 cases hysterectomy and radiotherapy in 2 cases. We found that the mean age was significantly higher (p less than 0.01) when the primary CIS lesion was localized in the cervix (36.8 +/- 10.5) compared to localization only on the portio (31.3 +/- 8.7). The risk of relapse was significantly higher (p less than 0.05) in patients where the primary cone had the lesion localized in the cervix compared to the patients where the primary cone had the lesion localized only to the portio. We found that the localization of PAD relapses appearing later compared to a high degree (about 65%) with the localization of the primary CIS lesion. Vaginal relapse was, generally speaking, twice as common when the primary CIS lesion was localized in the cervix compared to when it was localized on the portio alone. Alternative treatment methods to the conization operation are discussed and an increased individualization of CIS treatment is emphasized particularly with consideration to age and the localization of the CIS lesion.

摘要

在429例原位癌(CIS)女性患者中,我们发现在10年的随访期内,复发率为5.3%;414例患者的主要治疗方法为锥切术,13例为子宫切除术,2例为放射治疗。我们发现,与仅局限于宫颈外口(31.3±8.7岁)相比,原发性CIS病变局限于宫颈时的平均年龄显著更高(p<0.01)(36.8±10.5岁)。与原发性锥切病变仅局限于宫颈外口的患者相比,原发性锥切病变局限于宫颈的患者复发风险显著更高(p<0.05)。我们发现,PAD复发的部位与原发性CIS病变的部位相比,高度一致(约65%),但出现时间较晚。一般来说,原发性CIS病变局限于宫颈时的阴道复发率是仅局限于宫颈外口时的两倍。文中讨论了锥切术之外的其他治疗方法,并强调了CIS治疗的个体化,特别是考虑到年龄和CIS病变的部位。

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