宫颈上皮内瘤样病变Ⅱ、Ⅲ级行宫颈锥切术的临床价值

目的:探讨宫颈锥切术对于阴道镜下多点活检病理示宫颈上皮内瘤样病变(CIN)Ⅱ、Ⅲ级的诊断和治疗价值。方法:回顾性分析阴道镜下多点活检为CINⅡ级、CINⅢ级的患者共43例,采用自身对照法,对比阴道镜下多点活检、宫颈锥切术、全子宫切除术的病理结果。结果:阴道镜下多点活检对宫颈病变诊断的准确性仅为74.4%,其中11例病理升级,达25.6%。而宫颈锥切对宫颈病变诊断的准确性为100%,且宫颈锥切后再行全子宫切除术者术后病理100%降级。结论:宫颈锥切术具有诊断和治疗的双重作用,而且对于阴道镜下活检为CINⅢ级(包括原位癌)的患者,能进一步明确病变程度,是确定下一步治疗方案的不可逾越的过程。

The Clinical Value of Conization of Cervix in Cervical Intraepithelial Neoplasmia

Objective：To research on the clinical value of conization of cervix in CIN Ⅱ、CINⅢ by pathologic histology with the help of colposcope.Methods：43 cases of CIN by pathologic with the help of colposcope were retrospectively analysed focusing on the comparative study in pathology among cervical conization,colposcopic multiple biopsyes and hysterectomy.Results：Veracity of colposcopic multiple biopsyes was 74.4%,11cases pathology was serious（25.6%）,while the veracity of cervical conization was 100%,all of them after hysterectomy was degraded. Conclusion：Cordzation of cervix plays a very important role in the diagnosis and treatment of CIN. It should be taken for CIN HI by pathologic histology with the help of colposcope.