CAJ | 학술논문

目的：探讨宫颈上皮瘤样病变患者( CIN)经过宫颈环形电切术( LEEP)治疗后的病理分析,确定LEEP治疗在宫颈癌及其癌前病变中的诊断意义。方法将我院收治的309例经阴道镜下活检,病理诊断为CIN患者按照活检病理分成CIN1组、CIN2组、CIN3组,分别观察三组患者经过宫颈电切术术后病理与术前阴道镜下活检病理的差异。结果 CIN1组的电切术后标本与阴道镜下活检标本病理符合率为59.57%,升级40.42%；CIN2符合率为56.41%,升级率为8.97%,降级率为34.62%；CIN3符合率为71.17%,降级率为28.81%；对三组患者术后12个月进行HPV检测,发现CIN1组有2例患者复发,CIN2组有5例患者出现复发,CIN3组有1例患者复发,结果对三组复发率进行统计学分析结果差异不具有统计学意义(P>0.05)；CIN1组、CIN2组、CIN3组的无复发率分别为97.87%、96.79%,98.31%。三组HPV术前感染结果差异具有统计学意义(P<0.05)。结论 LEEP术后的病理更能准确的判断宫颈病变的真实情况,而LEEP术后的病理诊断升级,可避免漏诊,准确的指导治疗。
목적：탐토궁경상피류양병변환자( CIN)경과궁경배형전절술( LEEP)치료후적병리분석,학정LEEP치료재궁경암급기암전병변중적진단의의。방법장아원수치적309례경음도경하활검,병리진단위CIN환자안조활검병리분성CIN1조、CIN2조、CIN3조,분별관찰삼조환자경과궁경전절술술후병리여술전음도경하활검병리적차이。결과 CIN1조적전절술후표본여음도경하활검표본병리부합솔위59.57%,승급40.42%；CIN2부합솔위56.41%,승급솔위8.97%,강급솔위34.62%；CIN3부합솔위71.17%,강급솔위28.81%；대삼조환자술후12개월진행HPV검측,발현CIN1조유2례환자복발,CIN2조유5례환자출현복발,CIN3조유1례환자복발,결과대삼조복발솔진행통계학분석결과차이불구유통계학의의(P>0.05)；CIN1조、CIN2조、CIN3조적무복발솔분별위97.87%、96.79%,98.31%。삼조HPV술전감염결과차이구유통계학의의(P<0.05)。결론 LEEP술후적병리경능준학적판단궁경병변적진실정황,이LEEP술후적병리진단승급,가피면루진,준학적지도치료。
Objective To study the treatment of cervical electrotomy in cervical intraepithelial neoplasia ( CIN) patients and its re-currence, in order to provide advice on the prevention and treatment of HPV infection. Methods A total of 309 cases of CIN patients in our hospital treated by colposcopy and confirmed with biopsy were divided into group CIN1, group group CIN2 and group CIN3. The pathological differences after cervical electrotomy and those before colposcopy were observed in the three groups of patients. Results The qualified rate of group CIN1 type was 59. 57% in specimens with electric biopsy under colposcope resection specimen examination, and the upgrade rate was 40. 42%;the coincidence rate of group CIN2 was 56. 41%, the upgrade rate was 8. 97%, and the degradation rate was 34. 62%; the coincidence rate of group CIN3 was 71. 17%, and the degradation rate was 28. 81%;the HPV was detected 12 months after operation in the three groups, which found 2 cases in group CIN1, 5 cases in group CIN2 , and 1 case in group CIN3 had recurrence, but there was no statis-tical difference in the relapse rate of the three groups(P>0. 05);the recurrence-free rate of group CIN1, group CIN2 and CIN3 group was 97. 87%, 96. 79% and 98. 31%, respectively. The difference in preoperative infection Results of three groups before HPV was statistically significant (P<0. 05). Conclusion Cervical resection has a high coincidence rate of pathological specimens and preoperative colposcopic biopsy, and the pathological upgrade after LEEP conization may avoid the missed diagnosis and guide the treatment.