阴道镜活检与宫颈环形电切术在宫颈高级别上皮内瘤变诊治中的价值
The value of colposcope biopsy combined with loop electrosurgical excision procedure in the diagnosis and treatment of cervical high-grade intraepithelial neoplasia
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摘要: 目的:探讨阴道镜活检与宫颈环形电切术(LEEP)在宫颈高级别上皮内瘤变(CIN2~3)诊断及治疗中的价值。方法:将103例阴道镜活检诊断为CIN2~3的患者行阴道镜LEEP,对比LEEP前后病理符合结果。结果:103例手术均成功,术后病理仍为CIN2~3者80例,符合率77.67%;术后病理级别下降者21例(20.39%),其中16例为慢性宫颈炎,5例为CINⅠ;术后病理级别上升者2例(1.94%),均为宫颈浸润癌。结论:阴道镜取材有限,且无法取得宫颈管内的病变,在宫颈病变的诊断中有一定的局限性。LEEP切除病变范围和深度足够,两者联合使诊断和治疗CIN2~3更加完善。Abstract: Objective: To investigate the value of colposcope biopsy combined with loop electrosurgical excision procedure( LEEP) in the diagnosis and treatment of cervical high-grade intraepithelial neoplasia( CIN). Methods: One hundred and three patients with grade 2 and 3 CIN diagnosed by colposcope biopsy were treated with LEEP. The postoperative pathological findings were compared with the preoperative pathologic results. Results: The operations of 103 cases were successful. The postoperative pathology of 80 cases was still CIN 2 and 3,the coincidence rate of which was 77. 67%. The postoperative pathological levels of 21 cases( 20. 39%)( including chronic cervicitis in 16 cases and CIN 1 in 5 cases) declined. The postoperative pathological levels of 2 cases( 1. 94%)( cervical invasive carcinoma) increased. Conclusions: The colposcope cannot obtain the tissue of cervical canal lesions,which has certain limitation in the diagnosis of cervical lesions. LEEP resection can arrive at the enough scope and depth of lesion. The colposcope combined with LEEP can improve the diagnosis and treatment of grade 2 and 3 CIN.