Mateos Burguillo J F, Rodriguez Zarauz R, Uguet de Resayre C, Bajo Arenas J M
Department of Obstetrics and Gynaecology, Getafe University Hospital, Madrid.
Eur J Gynaecol Oncol. 1995;16(1):48-53.
Between April 1989 and December 1993, eight thousand one hundred women under cytologic suspect of human papillomavirus (HPV) cervical infection underwent new cytology, colposcopy, colposcopically directed exocervical biopsy, and, eventually, endocervical curettage. HPV cervical lesions were confirmed in 300 patients (3.7%), on the basis of at least, two positive diagnostic methods. Prior to surgery, the Papanicolaou smear was negative in 50 women, cervical intraepithelial neoplasia (CIN) I in 170 cases, CIN II in 70, and CIN III in the other 10 patients. Cryosurgery was practised in CIN I, II, or III and clinical condylomata (a total of 200 patients: 66.6%). Following cryosurgery, patients were seen six weeks and one year after for repeating cytology, colposcopy and cervical biopsy (if necessary). One-year-later cytology was negative in 230 cases (76.7%); 60 (20%) of CIN I; 7 (2.3%) of CIN II; and only one case of CIN III. At the same moment, colposcopy was normal in 66.6% of these patients. The incidence of cervical HPV (3.7%) is higher than the one referred by other authors, because of the use of endocervical curettage. We conclude the cryosurgery is quite a good therapeutic method in HPV cervical lesions.
1989年4月至1993年12月期间,8100名经细胞学检查怀疑人乳头瘤病毒(HPV)宫颈感染的女性接受了新的细胞学检查、阴道镜检查、阴道镜引导下的宫颈活检,最终还进行了宫颈管刮除术。基于至少两种阳性诊断方法,在300名患者(3.7%)中确诊了HPV宫颈病变。手术前,50名女性的巴氏涂片检查结果为阴性,170例为宫颈上皮内瘤变(CIN)I级,70例为CIN II级,另外10例为CIN III级。对CIN I、II、III级病变以及临床湿疣患者(共200例:66.6%)实施了冷冻手术。冷冻手术后,在六周和一年后对患者进行复查,重复进行细胞学检查、阴道镜检查及宫颈活检(如有必要)。一年后的细胞学检查结果显示,230例(76.7%)为阴性;CIN I级中有60例(20%);CIN II级中有7例(2.3%);CIN III级仅1例。与此同时,这些患者中有66.6%的阴道镜检查结果正常。由于使用了宫颈管刮除术,宫颈HPV的发病率(3.7%)高于其他作者报道的发病率。我们得出结论,冷冻手术是治疗HPV宫颈病变的一种相当不错的治疗方法。