Kalogirou D, Antoniou G, Karakitsos P, Botsis D, Kalogirou O, Giannikos L
2nd Department of Obstetrics and Gynecology, Areteion Hospital, Athens University, Greece.
Eur J Gynaecol Oncol. 1997;18(2):113-6.
To determine the interpretability and significance of the traditional factors used to predict residual dysplasia in hysterectomy specimens after loop conization.
Loop electrosurgical cervical conization was performed on 372 patients. Ninety three women had a hysterectomy within 6 months of the loop conization. Residual disease was defined as cervical intraepithelial neoplasia or cancer in the hysterectomy specimen.
Of the 93 patients having a subsequent hysterectomy, 36 (38.7%) has residual disease in their hysterectomy specimen. The mean age of the patients with residual disease in the post loop conization hysterectomy specimen was 42.22. The mean age of those free of residual disease was 29.42. By multivariate analysis, dysplasia involving the ectocervical margin (p = 0.34) and the endocervical margin (p = 0.35) was not predictive of disease in the hysterectomy specimens. Endocervical curettage (p = 0.005), glandular involvement (p = 0.01), loop conization pathology findings (p < 0.05) and cytological examination (p < 0.001) were predictive of residual dysplasia.
Cytological reports, increasing age, severity of disease, gland involvement and endocervical curettage were the only factors that accurately predicted residual dysplasia. The presence or absence of dysplasia in the loop conization, ectocervical margin and endocervical margin was not predictive of residual dysplasia in post loop conization hysterectomy specimens.
确定用于预测环形电切锥切术后子宫切除标本中残留发育异常的传统因素的可解释性及意义。
对372例患者实施环形电切宫颈锥切术。93名女性在环形电切锥切术后6个月内行子宫切除术。残留疾病定义为子宫切除标本中的宫颈上皮内瘤变或癌症。
在随后接受子宫切除术的93例患者中，36例（38.7%）子宫切除标本中有残留疾病。环形电切锥切术后子宫切除标本中有残留疾病患者的平均年龄为42.22岁。无残留疾病患者的平均年龄为29.42岁。多因素分析显示，宫颈外口切缘（p = 0.34）和宫颈内口切缘（p = 0.35）的发育异常不能预测子宫切除标本中的疾病。宫颈管刮术（p = 0.005）、腺体受累（p = 0.01）、环形电切锥切病理结果（p < 0.05）和细胞学检查（p < 0.001）可预测残留发育异常。
细胞学报告、年龄增加、疾病严重程度、腺体受累和宫颈管刮术是准确预测残留发育异常的唯一因素。环形电切锥切术中发育异常的有无、宫颈外口切缘和宫颈内口切缘不能预测环形电切锥切术后子宫切除标本中的残留发育异常。
