61例宫颈原位癌诊治分析

目的总结分析宫颈原位癌的诊治情况。方法对我院2000年1月至2007年5月住院治疗的61例原位癌进行回顾性分析。结果61例患者中,30岁以下者10例(16.4%),无任何症状19例(31.1%),接触性阴道出血22例(36.1%)。手术前后病理诊断符合率为67.2%(41/61),不符合率31.1%(19/61)。手术方式:宫颈冷刀锥切(CKC)3例,LEEP术5例,宫颈切除6例,全子宫切除±CKC 35例,次广泛子宫切除术11例,其他1例。2例行LEEP术后复发,1例CKC标本切缘发现C INⅠ级。结论宫颈原位癌的确诊应通过宫颈锥切手术,其中阴道镜下宫颈活检起着重要作用。对于年轻的宫颈原位癌可以行单纯的CKC手术治疗,以保留生育功能。对随诊困难、已经绝经及可疑早期浸润癌患者,可行全子宫切除术。

Clinical analysis of 61 cases of cervical carcinoma in situ

Objective To investigate the clinical character,diagnosis and treatment of cervical carcinoma in situ(CIS).Methods Sixty-one cases of CIS were analyzed retrospectively.Results The cervical multiple biopsy diagnosis accorded with surgical pathological diagnosis in 41 cases(67.2%),but there was no correspondence in 19 cases(31.1%).Two of the five patients suffering from CIS undergoing LEEP recurred.Conclusions Emphasis on screening is of importance for young and symptomless female patients.Cervical conization should be the first choice of treatment for CIS,and the patients should be followed up carefully after surgery.Cold knife conization(CKC)is a good choice for patient with CIS and desire for childbearing.Total hysterectomy seemed to be the first choice of treatment in CIS for those without desire for childbearing.