宫颈局部物理治疗和切除性治疗对子宫颈癌前病变转归的影响

目的探讨宫颈局部微波治疗、高频电波刀电圈切除术和冷刀锥切术对宫颈上皮内瘤样病变(cervical intraepithelial lesion,CIN)Ⅱ、Ⅲ级转归的影响。方法对289例2000年3月~2006年2月在我院门诊经阴道镜下宫颈活检病理诊断为CINⅡ、Ⅲ级者,按照我国中华医学会和美国阴道镜和宫颈病理学会制定的CIN的处理指南分别进行治疗和随访。结果233例完成随访(80.6%,233/289),随访时间3~56个月,平均11.8月。77.7%(181/233)的CINⅡ、Ⅲ级进行了治疗,其余22.3%(52/233)未治疗。治疗后CINⅡ、Ⅲ级病变消失率为88.4%(160/181),未治疗者病变消失率63.5%(33/52),差异有显著性(χ2=17.664,P=0.000)。CINⅡ级的微波治疗、高频电波刀电圈切除术和冷刀锥切术与病变转归无关(χ2=0.008,P=0.996),CINⅢ级采用冷刀锥切术与高频电波刀电圈切除术与病变消失无关(χ2=0.017,P=0.897)。结论CIN病变的治疗能提高CINⅡ、Ⅲ级的病变消失率,但3种治疗方法对CIN病变的转归差异无显著性。

Effects of Cervical Physical Therapy and Excisional Therapy on the Prognosis of Cervical Precancerous Lesions

Objective To investigate the prognosis of cervical intraepithelial neoplasia (CIN) Ⅱ and Ⅲ after being treated by microwave coagulation, loop electrosurgical excision procedure (LEEP) and cold knife conization. Methods From March 2000 to February 2006, 289 patients with CIN Ⅱ or Ⅲ diagnosed by colposcopic biopsy were treated and followed up according to consensus guidelines for the management of women with CIN. Results Totally 233 of the 289 patients (80.6%) completed the follow-up (3-56 months with a mean ...