LEEP治疗CIN 148例临床分析

目的:探讨宫颈电环圈切除术(LEEP)治疗宫颈上皮内瘤变(CIN)的临床价值及意义。方法:收集2007年1月～2008年6月来浦东新区妇幼保健院宫颈科就诊,阴道镜下活检,病理诊断为不同级别的CIN169例,对自愿行LEEP者148例进行临床分析,采用自身对照,对比研究阴道镜下多点活检和LEEP术后的病理检查结果。结果:阴道镜下多点活检和宫颈LEEP术后病理结果的符合率为93.24%。活检为CINⅠ的43例患者中,宫颈LEEP术后病理降级为慢性宫颈炎12例,占27.91%;术后病理保持为CINⅠ27例,占62.79%;术后病理升级为CINⅡ4例,占9.30%。活检为CINⅡ的78例患者中,宫颈LEEP术后病理降级23例,占29.49%(其中慢性宫颈炎12例,占15.38%,CINⅠ11例,占14.11%);术后病理保持为CINⅡ50例,占64.10%;术后病理升级为CINⅢ5例,占6.41%。活检为CINⅢ的27例患者中,宫颈LEEP术后病理降级9例,占33.33%(其中慢性宫颈炎1例,占3.70%,CINⅠ2例,占7.41%,CINⅡ6例,占22.22%);术后病理保持为CINⅢ17例,占62.96%;术后病理升级为宫颈癌1例,占3.70%。结论:对CIN患者实施LEEP治疗有重要的临床价值,不仅可以达到治疗的目的,更可以避免因阴道镜下活检遗漏更高级别的宫颈病变,甚至宫颈癌的进一步发展。

Clinical analysis of 148 cases of CIN treated by LEEP

Objective:To investigate the clinical value and significance of treating CIN with LEEP.Methods:Collected 169 cases of CIN identified by pathological diagnosis from January 2007 to June 2008 in our cervical clinic.148 cases who accepting LEEP treatment voluntarily were carried out clinical analysis,self-control was used to compare and study the results of multiple punch biopsy through colposcopy and pathological check after LEEP.Results:The coincidence was 93.24% between results of multiple punch biopsy through colposcopy and pathological check after LEEP.In 43 cases of biopsy to CINI,there were 12 cases of pathological results down-graded to chronic cervicitis accounting 27.91%;There were 27 cases of pathological results remained as CINI accounting 62.79%;There were 4 cases of pathological results up-graded to CINII accounting 9.30%.In 78 cases of biopsy to CINII,there were 23 cases of down-grade pathological results accounting 29.49%(among which,there were 12 cases of chronic cervicitis accounting 15.35%,there were 11 cases of CINI accounting 14.11%);There were 50 cases of pathological results remained as CINI accounting 64.10%;There were 5 cases of pathological results up-graded to CINIII accounting 6.41%.In 27 cases of biopsy to CINⅢ,there were 9 cases of down-grade pathological results accounting 33.33%(among which,there was 1 case of chronic cervicitis accounting 3.70%,there were 2 cases of CINI accounting 7.41%,there were 6 cases of CINII accounting 22.22%);There were 17 eases of pathological results remained as CINIII accounting 62.96%;There was 1 case of pathological results up-graded to cervical carcinoma accounting 3.70%.Conclusion:It is very significant to treat patients of CIN by LEEP.It not only can cure the disease but also can avoid the development of much more serious cervical diseases such as cervical carcinoma may be missed just by multiple punch biopsy through colonoscopy.