宫颈上皮内瘤变150例临床分析

目的：探讨宫颈上皮内瘤变（CIN）的诊断及治疗方法。方法：回顾分析1984年1月至1998年12月住院治疗的150例CIN的临床资料。结果宫颈细胞学检查诊断的阳性率为76．65，与宫颈管细胞学检查联合应用诊断的阳性率为78．8％，两者比较无显著性差异。细胞检查结合阴道镜下活检诊断CIN阳性率为95．3％，与单一细胞学诊断相比较，有显著性差异。阴道镜下活检与病理诊断的符合率为91．6％，镜下活检与宫颈管刮术结合诊断的阳性率明显高于单纯阴道镜下活检。141例采用手术治疗，无1例切缘阳性；9例原位癌采用腔内放疗，全组无1例复发或死亡。结论宫颈细胞学检查结合阴道镜检是诊断CIN的有效方法，对绝经后妇女应同时行宫颈管刮术，对不宜手术的原位癌患者可行单纯腔内放疗。

Diagnosis and Treatment of Cervical Intraepithelial Neoplasia

Objective To investigate the diagnosis and treatment of CIN.Methods One hundred and fifty inpatients with CIN treated in our hospital from January,1984 to December,1998 were retrospectively analyzed.Results The positive rate of cytology was 76.6%,which was 78.8% when combined with endocervical cytology( P >0.05).The positive rate of cytology combining colposcopically biopsy(95.3%) to diagnose CIN was significantly higher than that of cytology.The global agreement between colposcopically directed biopsy and final diagnosis was observed in 91.6%.141 patients underwent surgery with no positive margin,9 carcinoma in situ received intracavity radiotherapy alone.None of the patients recurred or died of the disease.Conclusion Cytology combining colposcopically directed biopsy is an effective method to diagnose CINs,ECC should be routinely performed in postmenopausal women.Intracavity radiotherapy alone may be as an alternative treatment for medically inoperable patient with carcinoma in situ of the cervix.