Chen R J, Lee E F, Shih J C
Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei.
Acta Obstet Gynecol Scand. 1994 Oct;73(9):726-9. doi: 10.3109/00016349409029412.
To assess the suitability of conized specimens obtained by loop electrosurgical excision procedure for histopathological interpretation.
We evaluated the histological pictures of 215 tissue sections obtained by loop electrosurgical excision procedure. These sections came from 32 cases of patients with various degrees of cervical intraepithelial neoplasia. All women included in our study had a satisfactory colposcopy and no cytological or colposcopic evidence of invasive cancer. We quantified the thickness of thermal damage in the tissue sections using a stage-mounted, calibrated grid microscope.
At its greatest extent, thermal damage occurring next to incision lines ranged from 160 to 520 mu (mean 262, SE 14 mu). Two different zones of thermal damage were produced by LEEP: the carbonization and coagulation zones. The carbonization zone was located at the outermost layer and was very thin, measuring from 10 to 30 mu in depth. The coagulation zone was adjacent to the carbonization zone, was eosinophilic, and was significantly deeper than the carbonization zone at its points of greatest thickness (150 to 500 mu; p < 0.0001, Student's t-test). The depth of the coagulation zone correlated significantly with the depth of the carbonization zone (p = 0.041, least linear correlation). Tissue distortion was present in 53% (17/32) of the cases, and appeared only in the coagulation zone.
Tissue structure from the diseased portions of the conized specimens was generally well preserved. The area of thermal damage was limited and thus did not result in diagnostic problems. We conclude that LEEP is a reliable method for obtaining tissue samples for histopathological examination.
评估经宫颈环形电切术获取的锥切标本用于组织病理学诊断的适宜性。
我们评估了经宫颈环形电切术获取的215个组织切片的组织学图像。这些切片来自32例不同程度宫颈上皮内瘤变的患者。纳入本研究的所有女性均有满意的阴道镜检查结果，且无浸润癌的细胞学或阴道镜证据。我们使用载物台安装的校准网格显微镜对组织切片中的热损伤厚度进行定量分析。
在切口线旁，热损伤最严重时范围为160至520微米（平均262微米，标准误14微米）。宫颈环形电切术产生了两个不同的热损伤区域：碳化区和凝固区。碳化区位于最外层，非常薄，深度为10至30微米。凝固区与碳化区相邻，呈嗜酸性，在其最厚处明显比碳化区深（150至500微米；p < 0.0001，Student t检验）。凝固区的深度与碳化区的深度显著相关（p = 0.041，最小线性相关）。53%（17/32）的病例存在组织变形，且仅出现在凝固区。
锥切标本病变部位的组织结构总体保存良好。热损伤面积有限，因此未导致诊断问题。我们得出结论，宫颈环形电切术是获取用于组织病理学检查的组织样本的可靠方法。
