宫颈锥形切除对阴道镜下多点活检诊断宫颈上皮内瘤样病变及早期宫颈癌的再评价

目的观察并分析宫颈锥形切除对阴道镜下多点活检诊断宫颈上皮内瘤样病变（cervical intraepithelial neoplasia,CIN）及早期宫颈癌的再评价,提高宫颈癌的确诊率,给疾病进一步治疗提供参考依据。方法对该院2005—2012年112例经阴道镜活检病理诊断CIN或早期宫颈癌的病人在LEEP刀下行宫颈锥切术再行病理检查病理诊断资料作回顾性分析。结果以宫颈锥切病理为准,CINⅠ23例,CINⅡ38例,CINⅢ34例,原位癌11例,浸润癌6例,对比阴道镜多点活检病理结果相符合有67例,不符合45例,其中诊断不足有21例,诊断过度24例。112例LEEP诊断为宫颈浸润癌的有11例,阴道镜下活检漏诊率为8.6%。结论阴道镜下多点宫颈活检对CIN的诊治有局限性,联合宫颈锥切可实现宫颈癌的正确诊断,并避免隐匿性宫颈癌的漏诊,可以对宫颈癌的进一步诊断提供重要参考依据。

Excision of the cervical cone biopsy under colposcopic diagnosis of cervical intraepithelial neoplasia and cervical cancer early re-evaluation

Objective To observe and analyze the excision of cervical cone biopsy under colposcopic cervical intraepithelial neoplasia and cervical cancer early re-evaluation to improve the diagnosis of cervical cancer,to provide a reference for further treatment of disease. Methods The hospital 112 cases in 2005 to 2012 by colposcopic biopsy diagnosis of CIN patients with early cervical cancer or cervical sword in LEEP conization biopsy pathology further data were analyzed retrospectively. Results The pathology of cervical conization prevail,CIN Ⅰ 23 Case,CIN Ⅱ 38 Case,CIN Ⅲ 34 cases,11 cases of carcinoma in situ,invasive carcinoma in 6 cases,contrast colposcopic biopsy results consistent with 67 cases,do not meet the 45 cases,of which underdiagnosis of 21 cases,24 cases of overdiagnosis. LEEP 112 cases of invasive cervical cancer are diagnosed in 11 cases,colposcopic biopsy missed was 8. 6%. Conclusion colposcopic cervical biopsy diagnosis of CIN limitations on joint conization can achieve a correct diagnosis of cervical cancer,and to avoid misdiagnosis of occult cancer,can provide important reference for further diagnosis of cervical cancer.