宫颈环形电切术后上皮内瘤变及切缘阳性者病灶残留分析

目的 探讨宫颈环形电切术(LEEP)后宫颈上皮内瘤变(CIN)且切缘阳性患者病灶的残留情况.方法 回顾性分析62例LEEP后CIN且切缘阳性并行子宫全切术患者的病理资料,将LEEP后病理与子宫全切术后病理进行比较.结果 62例LEEP后CIN且切缘阳性的患者子宫全切后病灶残留率达56.5%(35/62).单内切缘、单外切缘阳性和内外切缘皆阳性患者的病灶残留率比较,差异无统计学意义(P＞0.05).LEEP后切缘阳性部位与子宫全切后CIN不同级别的分布间差异有统计学意义(H=2.41,P＜0.05).LEEP后切缘阳性CIN Ⅱ级和CINⅢ级患者子宫全切后宫颈残留CIN病变的程度比较,差异无统计学意义(P＞0.05).LEEP后切缘阳性的CIN Ⅱ级和CIN Ⅲ级患者,单内、单外切缘阳性和内外切缘皆阳性者宫颈腺体累及率比较,差异均无统计学意义(P＞0.05).结论 LEEP后CIN且切缘阳性患者的后续处理需要综合评估,采取合适的措施,对内外切缘皆阳性患者要采取积极的治疗措施,宫颈病变的严重程度不能预测LEEP后是否有病灶残留;宫颈腺体累及率与病变的严重程度和切缘阳性部位无关.

Residual Lesions in Patients with Cervical Intraepithelial Neoplasia with Positive Resection Margin after Loop Electrosurgical Excision Procedure

Objective To explore the residual lesions in patients with cervical intraepithelial neoplasia(CIN) with positive resection margin after loop electrosurgical excision procedure(LEEP). Methods The pathological data of 62 CIN patients who had undergone both LEEP with positive resection margin and total hysterectomy were retrospectively reviewed,and the pathological findings after LEEP and after total hysterectomy were compared. Results The rate of residual lesion after total hysterectomy was 56.5%(35/62) in CI...