宫颈电圈切除术在宫颈上皮内瘤样病变诊断和治疗中的价值

目的：探讨行子宫颈电圈环除术（LEEP）诊断及治疗子宫颈上皮内瘤样病变（CIN）的效果。方法：将212例经阴道镜和细胞学检查及活组织病理检查诊断为CIN患者随机分成CO₂激光切割术组（116例）和LEEP组(96例)，切除组织全部进行病理学检查，并比较治疗效果。结果：LEEP术后病理确诊CIN 94例，治愈89例（治愈率94.7%），确诊为宫颈微小浸润癌者2例（2.1%）；术后复发5例（8.8%），其中切缘无病变累及者1例，有病变累及者4例；术后病理取材满意91例（满意率94.8%）。CO₂激光切割术组术后病理诊断均为CIN₁-2，治愈103例（治愈率88.8%）；术后复发13例（11.2%）；术后病理取材满意70例（满意率60.3%）。两组治愈率比较差异无显著性（P>0.05)；两组术后病理取材满意率比较差异具有显著性(P<0.001)。 结论：应用LEEP诊治CIN效果可靠，并可用于宫颈微小浸润癌的诊断。

Effects of loop electrosurgical excision procedure on diagnosis and treatment for cervical intraepithelial neoplasia

Objective To study the effects of loop electrosurgical excision procedure (LEEP) on diagnosis and treatment for cervical intraepithelial neoplasia (CIN). Methods 212 patients with CIN, identified by colposcopy, cytology and pathological biopsy, were randomly divided into two groups:CO 2 laser excision treated (116 cases) and LEEP treated (96 cases), all excised tissues were examined with pathological method. Results After LEEP treatment, 94 cases of CIN were pathologically confirmed, 94 8% confidence interval in specimens, 89 out of these were healed with a cure rate of 94 7%. Two cases of total (2 1%) were diagnosed as cervical microinvasive carcinoma. There were 5 cases of postoperative recurrence with a recurrence rate of 8 8%. Among them, 4 cases demonstrated readable resection margin while 1 case didn′t. In the group of CO 2 laser excision, all pathological postoperative diagnoses referred to CIN 1-2 . 103 cases were healed with a cure rate of 88 8%, and 13 cases observed as postoperative recurrence with the recurrence rate of 11 2% and the confidence interval in pathological specimens was 60 3%. There was significant difference of the confidence interval in pathological speciment postoperation between two groups ( P <0 001).Conclusion Application of LEEP is effective and reliable in CIN diagnosis and treatment, which is also applicable to diagnosis of cervical microinvasive carcinoma.