宫颈锥切术在宫颈上皮内瘤变诊治中的作用

目的：探讨宫颈锥形切除术在宫颈上皮内瘤变诊治中的价值。方法：收集2001年2月～2003年7月，同时做细胞学检查、阴道镜下多点活检以及宫颈锥形切除的患者72例作为研究对象，自身对照比较阴道镜下多点活检与宫颈锥形切除的病理结果的差异。结果：患者中位年龄32岁，30岁以下27例(37．5％)。未生育者43例(59．7％)。8例阴道镜下活检为CIN Ⅰ者，3例与锥切病理结果完全符合，2例低诊；37例CIN Ⅱ患者的锥切病理结果示13例(35．1％)两者相符，14例(37．8％)锥切病理结果的病变程度较多点活检重；19例CIN Ⅲ多点活检与锥切病理结果的符合率仅26．3％(5例)，活检低诊7例(36．8％)；7例CIS活检与锥切病理相符5例，另有CIN Ⅲ 1例、CIN Ⅰ 1例；对CIN Ⅱ及CIN Ⅲ阴道镜较容易出现低诊。3例患者锥切手术标本切缘见残留病变，均为环形电圈切除者，手术并发症主要是术后出血。短期随访未发现复发病例。结论：宫颈锥形切除既是一种明确诊断、决定进一步治疗方案的诊断方法，又是一种有效的的治疗手段．在宫颈上皮内瘤变及早期浸润癌的诊断和治疗中有其不可替代的独特价值。

Utility of Cervical Conization in Diagnosis and Treatment of Cervical Intraepithelial Neoplasia

Objective: To evaluate the value of cervical conization in diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Methods:72 patients with cervical intraepithelial neoplasia diagnosed at The international peace maternity & child health hospital of the China welfare institutes from Feb 2001 to Jul 2003 were retrospectively analyzed and comparative study the pathology results between cervical conization and colposcopic multiple biopsies. Results: the midian age of patients in this study was 32 years (range 21 - 56 years), 43 case unbearing. Of the 72 patiens, there was a correlation in pathology between cervical conization and multiple biopsies in 27 case (37. 5%), 23 case (31.9%) was low- diagnosed in colposcopic multiple biopsies, 6 patients with early invasive cancer and 1 patient with CIN III performed hysterectomy, follow up no cytology abnormal was detected and 5 patients had delivery. Conclusion: cervical conization is a can not be instead methods in diagnosis and treatment of CIN and is a safe choice for patients who desired childbearing.