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子宫颈高级别上皮内瘤变(CIN-III)冷冻手术的组织学评估

[Histological evaluation of cryosurgery in high grade intraepithelial neoplasia (CIN-III)] of the uterine cervix].

作者信息

Rojas I, Rodríguez T, Pierotic M, Le Cerf P

机构信息

Servicio de Obstetricia, Ginecología y Neonatología, Unidad de Oncología Ginecológica, Hospital Dr. Sótero del Río.

出版信息

Rev Chil Obstet Ginecol. 1993;58(3):200-4; discussion 204-5.

PMID:7991832
Abstract

Sixty patients, having high grade cervical intraepithelial neoplasia (CIN III) are analyzed. They are all treated primarily with cryosurgery followed, approximately 12 weeks thereafter, by cervical conization, in order to histologically evaluate the response to treatment. The mean follow up of the whole series was 36 months. Ninetieth five percentage of the patients were included in the series, having an abnormal PAP smear, suggesting presence of a CIN. Colposcopically directed biopsy prior to cryosurgery showed grade CIN III, with no glandular involvement in 61.7% of the cases. In 38.3% the endocervical glands were involved, cryotherapy was done in 60 patients, with single freezing in 26 (43.3%) and double freezing in 34 (53.7%) patients. On analyzing the cone specimen, 71.7% of the cases showed no residual disease. The group that received double freezing did better than the single one (79 versus 61%). As well, the group with out gland involvement did better than the group showing such condition (83.8 versus 52.2%). Cryosurgery is a good therapeutic modality in cases with CIN III, following street selection criteria and having a good and reliable follow up.

摘要

对60例高级别宫颈上皮内瘤变(CIN III)患者进行了分析。她们均首先接受冷冻手术治疗,大约12周后进行宫颈锥切术,以便从组织学上评估治疗反应。整个系列的平均随访时间为36个月。该系列纳入了95%的患者,她们的巴氏涂片异常,提示存在CIN。冷冻手术前的阴道镜引导活检显示为CIN III级,61.7%的病例无腺体受累。38.3%的病例宫颈管腺体受累,60例患者接受了冷冻治疗,26例(43.3%)单次冷冻,34例(53.7%)双次冷冻。分析锥切标本时,71.7%的病例未显示残留疾病。接受双次冷冻的组比单次冷冻的组效果更好(79%对61%)。同样,无腺体受累组比有腺体受累组效果更好(83.8%对52.2%)。按照严格的选择标准并进行良好且可靠的随访,冷冻手术是治疗CIN III病例的一种良好治疗方式。

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