宫颈电热圈环切术在宫颈病变中的诊疗价值

目的探讨宫颈电热圈环切术(LEEP)在诊断和治疗宫颈病变中的临床价值。方法回顾性分析2005年6月—2007年6月间我院门诊接受LEEP治疗的242例宫颈病变患者的临床病理资料。结果90例慢性宫颈炎中检出5例轻度不典型增生,1例原位癌,检出率为6.6%(6/90)。152例各种CIN病例中术前术后病理诊断一致者占57.2%(87/152),术后级别升高占13.8%(21/152),其中早期浸润癌1例。11例原位癌患者行LEEP治疗后,定期复查,4例未发现病灶;2例再次LEEP,二次LEEP后活检未发现病灶;5例行子宫全切术中仅有1例全切后宫颈标本上仍有原位癌灶;1例因行LEEP术后病检为有小灶性浸润,全切术后病检为浸润癌深度<0.5mm;其余3例均未发现病灶。8例未生育的CIN患者行LEEP,其中4例分别于术后半年成功受孕,1例成功分娩。结论LEEP可弥补阴道镜活检的不足,提高宫颈病变的确诊率;治疗效果好,简单易行,但对原位癌的治疗仍需斟酌。

Value of the LEEP in Diagnosing and Treating Cervical Diseases

Objective To explore the clinical value of loop eleclrosurgical excision precedure(LEEP)in diag- nosing and treating cervical diseases.Methods the clinicopathologic data of 242 cases with cervical diseases who were treated with LEEP in the OPt of our hospital from June 2005 to June 2007 were reviewed retrospective- ly.Results 5 cases of slight atypical hyperplasia and 1 sample of CIS in 90 cases of chronic cervicitis were de- tected.The detection rate was 6.6 %(6/90).The pre-operative pathologic diagnosis of 57.2 %(87/152)cases of 152 CIN patients remained the same compared with after operation.13.8%(21/152)cases upgraded after op- eration,including 1 case of early invasive carcinoma.11 CIS patients accepted LEEP and re-examed later. There was no nidus found in 4 of them.2 of them accepted a secondary LEEP and no nidus found with biospy af- ter operation.5 patients accepted TH.Only one of them still had CIS nidus in cervix.Another case of the 5 found small focal infiltration after LEEP,and it was proved that the infiltrating depth was less than 0.5mm after TH.There was no nidus found in the other 3 of the 5 patients after operation.8 CIN patients without procreation accepted IEEP 4 of them were fertilized respectively after 6 months,and one delivered successfully.Conclu- sions LEEP can retrieve the shortage of vaginoscopy and increase the detection rate of cervical diseases.Treat- ing cervical disease with LEEP is easy and effective.However,treating CIS with LEEP still need taking more considerations.