中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
CHINESE JOURNAL OF MATERNAL AND CHILD HEALTH RESEARCH
2014年
2期
266-268
,共3页
阴道镜多点活检%宫颈管搔刮%宫颈环形电切术%宫颈上皮内瘤变
陰道鏡多點活檢%宮頸管搔颳%宮頸環形電切術%宮頸上皮內瘤變
음도경다점활검%궁경관소괄%궁경배형전절술%궁경상피내류변
colposcopic multiple biopsy%endocervical curettage%cervical loop electrosurgical excision procedure ( LEEP )%cervical intraepithelial neoplasia ( CIN)
目的：探讨阴道镜下宫颈多点活检及宫颈管搔刮联合宫颈环形电切术（ LEEP）在宫颈上皮内瘤变（ CIN）中的临床诊断价值。方法选取2012年1月至2013年6月在杭州市江干区人民医院妇科行液基细胞学筛查（ TCT）检测异常的108例患者为研究对象，行阴道镜下多点活检及宫颈管搔刮，并对其中阴道镜下确诊为CIN及以上的68例患者行LEEP术的治疗及进一步诊断。结果 TCT诊断中异常的108例患者中，意义不明确的不典型鳞状细胞（ ASC-US）28例，不除外高度病变的不典型鳞状上皮细胞（ASC-H）22例，低度鳞状上皮内瘤变（LSIL）32例，高度鳞状上皮内瘤变（HSIL）20例，鳞状细胞癌（SCC）6例；与阴道镜活检诊断符合70例，符合率为64．81％。阴道镜下活检诊断，CINⅠ级16例，CINⅡ级12例，CINⅢ级10例，鳞状细胞癌6例，原位癌2例，浸润癌1例，颈管腺癌1例，与 LEEP 手术病理诊断符合60例，符合率为83．33％。 LEEP 术后治愈68例（100．00％），复发3例（4．41％），并发症发生率2例（2．94％）。结论阴道镜下活检及宫颈管搔刮准确率高于TCT准确率，阴道镜下多点活检及宫颈管搔刮联合LEEP术可提高CIN高级别诊断准确率，具有较高的临床应用价值。
目的：探討陰道鏡下宮頸多點活檢及宮頸管搔颳聯閤宮頸環形電切術（ LEEP）在宮頸上皮內瘤變（ CIN）中的臨床診斷價值。方法選取2012年1月至2013年6月在杭州市江榦區人民醫院婦科行液基細胞學篩查（ TCT）檢測異常的108例患者為研究對象，行陰道鏡下多點活檢及宮頸管搔颳，併對其中陰道鏡下確診為CIN及以上的68例患者行LEEP術的治療及進一步診斷。結果 TCT診斷中異常的108例患者中，意義不明確的不典型鱗狀細胞（ ASC-US）28例，不除外高度病變的不典型鱗狀上皮細胞（ASC-H）22例，低度鱗狀上皮內瘤變（LSIL）32例，高度鱗狀上皮內瘤變（HSIL）20例，鱗狀細胞癌（SCC）6例；與陰道鏡活檢診斷符閤70例，符閤率為64．81％。陰道鏡下活檢診斷，CINⅠ級16例，CINⅡ級12例，CINⅢ級10例，鱗狀細胞癌6例，原位癌2例，浸潤癌1例，頸管腺癌1例，與 LEEP 手術病理診斷符閤60例，符閤率為83．33％。 LEEP 術後治愈68例（100．00％），複髮3例（4．41％），併髮癥髮生率2例（2．94％）。結論陰道鏡下活檢及宮頸管搔颳準確率高于TCT準確率，陰道鏡下多點活檢及宮頸管搔颳聯閤LEEP術可提高CIN高級彆診斷準確率，具有較高的臨床應用價值。
목적：탐토음도경하궁경다점활검급궁경관소괄연합궁경배형전절술（ LEEP）재궁경상피내류변（ CIN）중적림상진단개치。방법선취2012년1월지2013년6월재항주시강간구인민의원부과행액기세포학사사（ TCT）검측이상적108례환자위연구대상，행음도경하다점활검급궁경관소괄，병대기중음도경하학진위CIN급이상적68례환자행LEEP술적치료급진일보진단。결과 TCT진단중이상적108례환자중，의의불명학적불전형린상세포（ ASC-US）28례，불제외고도병변적불전형린상상피세포（ASC-H）22례，저도린상상피내류변（LSIL）32례，고도린상상피내류변（HSIL）20례，린상세포암（SCC）6례；여음도경활검진단부합70례，부합솔위64．81％。음도경하활검진단，CINⅠ급16례，CINⅡ급12례，CINⅢ급10례，린상세포암6례，원위암2례，침윤암1례，경관선암1례，여 LEEP 수술병리진단부합60례，부합솔위83．33％。 LEEP 술후치유68례（100．00％），복발3례（4．41％），병발증발생솔2례（2．94％）。결론음도경하활검급궁경관소괄준학솔고우TCT준학솔，음도경하다점활검급궁경관소괄연합LEEP술가제고CIN고급별진단준학솔，구유교고적림상응용개치。
Objective To investigate the clinical value of colposcopic multiple biopsy and endocervical curettage combining cervical loop electrosurgical excision procedure (LEEP) in diagnosis of cervical intraepithelial neoplasia (CIN).Methods From January 2012 to June 2013 108 cases of women were detected with abnormal results by TCT in gynecology department of Jianggan District People ’ s Hospital of Hangzhou .Colposcopic multiple biopsy and endocervical curettage were performed to them , and 68 cases diagnosed with CIN or higher grade by colposcopy underwent LEEP for further diagnosis .Results Among 108 cases with abnormal results in TCT , there were 28 cases of ASC-US, 22 cases of ASC-H, 32 cases of LSIL, 20 cases of HSIL, and 6 cases of SCC.There were 70 cases in accordance with colposcopic biopsy (64.81%).There were 16 cases of CIN grade Ⅰ, 12 cases of CIN Ⅱ, 10 cases of CIN Ⅲ, 6 cases of squamous cell carcinoma, 2 cases of cancer in situ, 1 case of infiltrating carcinoma and 1 case of adenocarcinoma of cervical canal diagnosed by colposcopy, among which 60 cases accorded with LEEP surgical pathology diagnosis and the coincidence rate was 83.33%.After LEEP surgery, 68 cases were cured (100.00%), 3 cases relapsed (4.41%) and the incidence of complications was 2.94% (2 cases). Conclusion Colposcopic biopsy and endocervical curettage is more accurate than TCT .Colposcopic multiple biopsy and endocervical curettage combined with LEEP can improve the diagnostic accuracy of high grade of CIN with high clinical value .
