Kennedy A W, elTabbakh G H, Biscotti C V, Wirth S
Department of Gynecology, Cleveland Clinic Foundation, Ohio 44195, USA.
Gynecol Oncol. 1995 Aug;58(2):274-7. doi: 10.1006/gyno.1995.1226.
Adenocarcinoma in situ (AIS) of the cervix is a controversial entity which is being encountered with increasing frequency. Current critical issues in its management are the safety of uterine preservation in younger patients and the use of LLETZ conization. A 28-year-old patient was diagnosed with AIS and managed with LLETZ. Despite apparently negative margins of resection in the initial conizations, the patient was found to have invasive adenocarcinoma 1 year later. It is concluded, after review of the pathologic features of AIS, that if conservative management of AIS is elected, then standard cold knife conization should be performed and not LLETZ. Further study is required to establish the overall safety of conservative treatment of cervical AIS, including the use of LLETZ.
宫颈原位腺癌（AIS）是一个存在争议的实体，其发病率正日益增加。目前在其治疗中关键的问题是年轻患者保留子宫的安全性以及使用大环状电切术（LLETZ）进行锥切。一名28岁的患者被诊断为AIS，并接受了LLETZ治疗。尽管最初的锥切术中切缘看似阴性，但该患者在1年后被发现患有浸润性腺癌。在回顾了AIS的病理特征后得出结论，如果选择对AIS进行保守治疗，那么应采用标准的冷刀锥切术而非LLETZ。需要进一步研究以确定宫颈AIS保守治疗的整体安全性，包括LLETZ的使用。
