宫颈锥型切除边缘阳性病例的研究

目的 探讨宫颈锥型切除边缘阳性病例的最佳处理方法。方法 1996年1月1日－1998年6月30日间法国马赛妇幼医院妇产科进行了220例宫颈锥型切除术，对其中73例边缘阳性者分别于术后3、6、12、18、24月行宫颈刮片、阴道镜检查并随访。结果 7例因侵润性癌而行放疗；17例再次行宫锥型切除术或全子宫切除术，其中8例有病灶残留者均为标本上级即靠近宫颈内口处阳性，病灶残留率为47．06％（8／17）；40例无需进一步治疗；9例失访。结论 宫颈锥型切除边缘阳性病例中，正规随访很重要。宫颈刮片，阴道镜检查可提供有效的随访依据和再次行宫 颈锥型切除术的指征。

Experience in Managing 73 Patients with Positive Margins afterCervical Conization

Objective To study the proper treatment of the patient with positive margins after cervical conization. Methods A total of 220 cervical conizations were performed in the department of obstetrics and gynecology in Conception Hospital in Marseille in France from January 1, 1996 to June 30, 1998. Among them, we studied 73 patients, who had positive margins, by using cervical cytology examination and colposcopy in 3,6,12,18 and 24 months after cervical conization. Results 7 cases of cancer invasive were treated with radiotherapy; 17 underwent a second conization or hysterectomy, among whom 8 had residual disease of positive margins near internal orifice of uterus (residual rate, 47.06% ); 40 remained follow-up; but 9 were lost. Conclusion Cytology and colposcopy are effective in the surveillance of patients with positive margins after cervical conization, and can give the indication of the second conization.