中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
15期
1169-1172
,共4页
宫颈癌%锥形切术%残留病灶%再次手术
宮頸癌%錐形切術%殘留病竈%再次手術
궁경암%추형절술%잔류병조%재차수술
Cervical cancer%Conization%Residual diseases%Repeat surgery
目的 探讨宫颈冷刀锥切术对宫颈癌的诊断价值及锥切术后宫颈癌患者的进一步治疗.方法 回顾性分析2008至2012年于北京大学人民医院行宫颈锥切术后诊断宫颈癌的患者56例的临床诊疗情况,并与阴道镜下进行活体组织检查病理学比较.结果 (1)56例锥切术后确诊的宫颈癌中,Ⅰ a1期39例,Ⅰa2期2例,Ⅰ b1期15例.与术前阴道镜活体组织检查病理学诊断比较,诊断不一致46例(82.1％);(2)39例Ⅰ a1期宫颈癌患者中,23例接受了再次手术,术后病理组织学检查提示宫颈仍然有病灶残余12例(52.2％),残余病灶分别为CIN15例、CIN Ⅱ3例、CIN Ⅲ3例;16例未行再次手术患者,随访未发现异常;(3)Ⅰ a2期、Ⅰ b1期患者均行2次手术,8例予术前化疗,其中Ⅰa2期1例,Ⅰ b1期7例.结论 宫颈锥切术在宫颈病变的诊断和治疗中具有重要价值,锥切后诊断宫颈癌的临床处理,应根据患者年龄、病变程度、切缘状态、生育要求等制定个体化、综合考虑以决定进一步的治疗方案.
目的 探討宮頸冷刀錐切術對宮頸癌的診斷價值及錐切術後宮頸癌患者的進一步治療.方法 迴顧性分析2008至2012年于北京大學人民醫院行宮頸錐切術後診斷宮頸癌的患者56例的臨床診療情況,併與陰道鏡下進行活體組織檢查病理學比較.結果 (1)56例錐切術後確診的宮頸癌中,Ⅰ a1期39例,Ⅰa2期2例,Ⅰ b1期15例.與術前陰道鏡活體組織檢查病理學診斷比較,診斷不一緻46例(82.1％);(2)39例Ⅰ a1期宮頸癌患者中,23例接受瞭再次手術,術後病理組織學檢查提示宮頸仍然有病竈殘餘12例(52.2％),殘餘病竈分彆為CIN15例、CIN Ⅱ3例、CIN Ⅲ3例;16例未行再次手術患者,隨訪未髮現異常;(3)Ⅰ a2期、Ⅰ b1期患者均行2次手術,8例予術前化療,其中Ⅰa2期1例,Ⅰ b1期7例.結論 宮頸錐切術在宮頸病變的診斷和治療中具有重要價值,錐切後診斷宮頸癌的臨床處理,應根據患者年齡、病變程度、切緣狀態、生育要求等製定箇體化、綜閤攷慮以決定進一步的治療方案.
목적 탐토궁경냉도추절술대궁경암적진단개치급추절술후궁경암환자적진일보치료.방법 회고성분석2008지2012년우북경대학인민의원행궁경추절술후진단궁경암적환자56례적림상진료정황,병여음도경하진행활체조직검사병이학비교.결과 (1)56례추절술후학진적궁경암중,Ⅰ a1기39례,Ⅰa2기2례,Ⅰ b1기15례.여술전음도경활체조직검사병이학진단비교,진단불일치46례(82.1％);(2)39례Ⅰ a1기궁경암환자중,23례접수료재차수술,술후병리조직학검사제시궁경잉연유병조잔여12례(52.2％),잔여병조분별위CIN15례、CIN Ⅱ3례、CIN Ⅲ3례;16례미행재차수술환자,수방미발현이상;(3)Ⅰ a2기、Ⅰ b1기환자균행2차수술,8례여술전화료,기중Ⅰa2기1례,Ⅰ b1기7례.결론 궁경추절술재궁경병변적진단화치료중구유중요개치,추절후진단궁경암적림상처리,응근거환자년령、병변정도、절연상태、생육요구등제정개체화、종합고필이결정진일보적치료방안.
Objective To evaluate the clinical value of conization in the diagnosis of cervical cancer to optimize its management.Methods Fifty-six patients diagnosed with cervical cancer after conization at our hospital between 2008 and 2012 were reviewed.The pathological profiles of colposcopic multiple biopsies and treatment options were analyzed.Results Among them,there were stage Ⅰ a1 (n =39),stage Ⅰ a2 (n =2) and stage Ⅰ b1 (n =15).And there was not much correspondence between cervical conization and colposcopic multiple biopsies in 46 cases.Among 23 patients with stage Ⅰ a1 undergoing further surgery,12 (52.17％) had residual diseases,including CIN Ⅰ (n =5),CIN Ⅱ (n =3),CINⅢ(n =3).No recurrence was found in 16 cases without further surgical intervention.All cases of stages Ⅰ a2 and Ⅰ b1 underwent repeat surgery while 8 cases received preoperative chemotherapy,including stage Ⅰ a2 (n =1) and stage Ⅰ b2 (n =7).Conclusion Cold knife conization plays a very important role in the diagnosis and treatment of cervical diseases.Further treatment options should be selected individually and comprehensively based on such factors as patient age,degrees of dysplasia,surgical margin status,fertility requirements and so on.
