宫颈原位癌及微浸癌的诊断及治疗 附145例临床分析

145例宫颈原位癌及微浸癌的阴道镜下直接活检与术后病理诊断之符合率为94.56％。原位癌行子宫全切术,微浸癌行次广泛子宫切除术,随访5年以上119例,5年及10年存活率均为100％。讨论了早期宫颈癌的诊断及治疗问题。

CARCINOMA IN SITU AND MICROINVASIVE CARCINOMA OF THE CERVIX-A CLINICAL ANALYSIS OF 145 CASES

145 cases of in situ and microinvasive cervical cancer were treated and retrospectively analyzed. Final diagnosis was made according to histological examination. Definition of microinvasive carcinoma was limited to a depth of 3 mm invasion excluding lymphatic and vascular involvement with a confluent pattern. The accuracy of cytology as compared with the histologic diagnosis was 78.7%.The accuracy of colposcopically directed biopsy was 94.6%. Operations for carcinoma in situ were total hysterectomy and Telinde modification of hysterectomy. The Class-2 expanded hysterectomy was used for microinvasive cervical cancer. 119 cases have been followed for more than 5 years, the five-year and ten-year survival rate were 100% for each group. It is stated that the correct use of colposcopically directed biopsy demonstrates a high accuracy for diagncsis and affords the avoidance of unnecessary cone biopsy. When reproductive function is no longer important, total hysterectomy is the most effective measure for carcinoma in situ. A Class-2 expanded hysterectomy can prevent central recurrence and facilitate post operative irradiation in case of misdiagnosed invasive carcinoma.