Flannelly G, Langhan H, Jandial L, Mana E, Campbell M, Kitchener H
Wellbeing Centre for the Prevention of Cervical Cancer, Aberdeen Royal Hospitals NHS Trust, UK.
Br J Obstet Gynaecol. 1997 Jun;104(6):718-22. doi: 10.1111/j.1471-0528.1997.tb11983.x.
To examine the long term efficacy of large loop excision of the transformation zone (LLETZ) in the treatment of cervical intraepithelial neoplasia (CIN) and to evaluate the relative diagnostic merits of colposcopy and cytology in the follow up of these women.
A retrospective examination of cytology, colposcopy and histology records of the first 1000 women treated with LLETZ in Aberdeen from 1989 to 1991.
Colposcopy Clinic Aberdeen Royal Infirmary, Grampian Region, Scotland.
Nine hundred and seventy-seven women (97.7%) were seen for follow up at least once and 317 were followed for as long as four years. This comprises 2812 woman years of follow up. The incidence of recurrent CIN was 27/1000 woman years and the cumulative rate of recurrence at four years was 10.1 per 100 women. Twenty-eight of the 59 women (47%) with abnormal colposcopy and proven CIN had a concurrent smear that did not show dyskaryosis.
LLETZ is an effective from of treatment for CIN. Colposcopy was useful in the follow up of these women and expedited the treatment of persistent disease. We recommend that any follow up protocol should include a colposcopic assessment and cytological follow up for at least four years following treatment. Further data are required to determine the risk of recurrence beyond this time.
探讨转化区大环形切除术（LLETZ）治疗宫颈上皮内瘤变（CIN）的长期疗效，并评估阴道镜检查和细胞学检查在这些女性随访中的相对诊断价值。
对1989年至1991年在阿伯丁接受LLETZ治疗的前1000名女性的细胞学、阴道镜检查和组织学记录进行回顾性研究。
苏格兰格兰扁地区阿伯丁皇家医院阴道镜诊所。
977名女性（97.7%）至少接受了一次随访，317名女性随访长达四年。这包括2812个女性年的随访。CIN复发率为每1000女性年27例，四年累计复发率为每100名女性10.1例。59名阴道镜检查异常且确诊为CIN的女性中，有28名（47%）同时涂片未显示核异常。
LLETZ是治疗CIN的有效方法。阴道镜检查对这些女性的随访有用，并加快了持续性疾病的治疗。我们建议任何随访方案都应包括治疗后至少四年的阴道镜评估和细胞学随访。需要更多数据来确定这段时间之后的复发风险。
