Naumann R W, Bell M C, Alvarez R D, Edwards R P, Partridge E E, Helm C W, Shingleton H M, McGee J A, Higgins R V, Hall J B
University of Alabama at Birmingham 35233-7333.
Gynecol Oncol. 1994 Nov;55(2):224-8. doi: 10.1006/gyno.1994.1281.
Large loop excision of the transformation zone (LLETZ) provides a pathologic specimen similar to a cold-knife cone (CKC) biopsy of the cervix. One hundred twenty women with indications for a cone biopsy were evaluated with LLETZ to determine if this procedure is an acceptable alternative to traditional cold-knife conization of the cervix. All patients had LLETZ performed in the clinic under local anesthesia. An average of 2.1 slices was required to remove the transformation zone. Coagulation artifact interfered with histologic diagnosis in only 1.8% of specimens. The number of slices taken during the LLETZ procedure significantly correlated with the amount of heat artifact in the pathology specimen (P = 0.02) and interfered with the ability of the pathologist to determine complete excision of dysplasia (P = 0.03). LLETZ is an acceptable alternative to diagnostic CKC and can offer a substantial cost savings. To facilitate histopathologic interpretation, every effort should be made to minimize the number of slices and to maintain orientation of the LLETZ specimen. Endocervical curettage performed after LLETZ can identify a group of patients who are at high risk for CIN recurrence.
转化区大环形切除术（LLETZ）所提供的病理标本与宫颈冷刀锥切术（CKC）活检相似。对120例有宫颈锥切活检指征的女性进行了LLETZ评估，以确定该手术是否可作为传统宫颈冷刀锥切术的可接受替代方法。所有患者均在门诊接受局部麻醉下的LLETZ手术。平均需要2.1片来切除转化区。凝血假象仅在1.8%的标本中干扰组织学诊断。LLETZ手术过程中所取切片数量与病理标本中的热假象量显著相关（P = 0.02），并干扰病理学家确定发育异常完全切除的能力（P = 0.03）。LLETZ是诊断性CKC的可接受替代方法，并且可以大幅节省成本。为便于组织病理学解释，应尽一切努力减少切片数量并保持LLETZ标本的方向。LLETZ术后进行宫颈管刮除术可识别一组CIN复发风险高的患者。
