Phelps J Y, Ward J A, Szigeti J, Bowland C H, Mayer A R
Brooke Army Medical Center, San Antonio, Texas.
Obstet Gynecol. 1994 Jul;84(1):128-30.
To determine the relation between dysplasia at cervical cone margins and the presence or absence of residual dysplasia in post-cone hysterectomy specimens.
We performed a 6-year retrospective, multicenter study and reviewed 250 cases in which the patient had a cold-knife cervical cone biopsy followed by a hysterectomy within 6 months. Pathology reports from 23 institutions described the margins in conization specimens and the subsequent status of residual dysplasia in the hysterectomy specimens.
There was a statistically significant difference in the prevalence of residual dysplasia in hysterectomy specimens between patients with positive margins on cone biopsy (47%) and those with negative margins (23%) (P < .01). The positive predictive value for residual dysplasia given positive cone margins was 47%, and the negative predictive value was 77%. The grade of post-cone residual dysplasia increased commensurately with the grade of dysplasia in the conization specimen.
The presence of dysplasia at the cervical cone margin relates significantly with the presence of residual dysplasia in the post-cone hysterectomy specimen. The grade of residual dysplasia in the post-cone hysterectomy specimen increased as the grade of dysplasia in the conization specimen increased. Free margins on a cone biopsy specimen with dysplasia offer reassurance that invasive cancer is not present in the remaining uterus.
确定宫颈锥切边缘发育异常与锥切术后子宫切除标本中是否存在残留发育异常之间的关系。
我们进行了一项为期6年的回顾性多中心研究，回顾了250例患者，这些患者均接受了冷刀宫颈锥切活检，并在6个月内进行了子宫切除术。来自23个机构的病理报告描述了锥切标本的边缘情况以及子宫切除标本中残留发育异常的后续状况。
锥切活检边缘阳性的患者子宫切除标本中残留发育异常的患病率（47%）与边缘阴性的患者（23%）之间存在统计学上的显著差异（P <.01）。锥切边缘阳性时残留发育异常的阳性预测值为47%，阴性预测值为77%。锥切术后残留发育异常的分级与锥切标本中发育异常的分级相应增加。
宫颈锥切边缘存在发育异常与锥切术后子宫切除标本中存在残留发育异常显著相关。锥切术后子宫切除标本中残留发育异常的分级随着锥切标本中发育异常分级的增加而增加。锥切活检标本边缘无发育异常可让人放心，剩余子宫中不存在浸润性癌。
