阴道镜活检联合子宫颈环形电刀在宫颈微小浸润癌患者中的应用效果
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王芳,E-mail:529691909@qq.com;Tel:18961322202

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Effect of LEEP knife combined with biopsy in patients with small invasive cervical cancer
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    目的??探究阴道镜活检联合子宫颈环形电刀(LEEP刀)锥切术在宫颈微小浸润癌患者中的应用效果。方法 回顾性分析2013年6月-2016年6月该院经LEEP锥切术诊断为微小浸润癌的66例患者的临床资料。术前66例患者均经阴道镜活检,比较阴道镜活检与LEEP锥切术对微小浸润癌诊断的情况,不同间质浸润深度和切缘情况患者LEEP锥切术后病变残留情况。结果 阴道镜活检检出2例轻度鳞状细胞上皮内瘤变(LSIL)、60例重度鳞状上皮内瘤变(HSIL)、1例宫颈原位腺癌(AIS),3例患者诊断为子宫颈微小浸润癌或可疑子宫颈微小浸润癌,敏感度为4.54%,漏诊率为95.46%;LEEP锥切术检出1例LSIL、44例HSIL、1例AIS,20例切缘阴性。3组患者LEEP锥切术切除组织的厚度和面积差异无统计学意义(P >0.05)。微小浸润癌组患者切除组织的深度明显高于HSIL及AIS组,HSIL及AIS组患者切除组织的深度高于LSIL组,差异具有统计学意义(P <0.05)。间质浸润深度≤1 mm组、1 mm<间质浸润深度≤3 mm组和3 mm<间质浸润深度≤5 mm组患者的术后病变残留率分别为15.00%、19.51%和20.00%,差异无统计学意义(P >0.05)。内切缘阳性组、外切缘阳性组和纤维间质切缘阳性组患者的术后病变残留率分别为25.00%、15.38%和23.80%,差异无统计学意义(P >0.05)。结论 单纯阴道镜活检诊断子宫颈微小浸润癌漏诊率较高,联合LEEP锥切术诊断能够提高诊断率。

    Abstract:

    Objective?To explore the effect of the application of cervical loop electric knife (LEEP) in the patients with cervical micro invasive cancer.?Methods?Clinical data of 66 patients with minimal invasive carcinoma diagnosed by LEEP cone resection in our hospital from June 2013 to June were retrospectively analyzed. Preoperative and postoperative patients with LEEP were compared with 66 patients who underwent biopsy with biopsy, the diagnosis of micro invasive carcinoma was compared with LEEP cone resection.?Results?The results of colposcopy biopsy were detected in 2 cases of LSIL, 60 cases of HSIL and 1 cases of AIS, 3 cases were diagnosed as cervical microinvasive carcinoma or suspicious cervical microinvasive carcinoma, the sensitivity was 4.54%, the misdiagnosis rate was 95.46%; LEEP conization were detected in 1 cases of LSIL, 44 cases of HSIL and 1 cases of AIS, 20 cases negative margin. There was no significant difference in the thickness and area of the resected tissue between the three groups (P > 0.05). The depth of the resected tissue was significantly higher than that in the HSIL and AIS group, the HSIL and AIS groups were significantly higher than the LSIL group, the difference was statistically significant (P < 0.05). Interstitial infiltration depth is less than or equal to 1mm group, the 1 “depth of stromal invasion than 3mm group and 3 < rate were 15.00%, 19.51% and 20.00% of the remaining lesion depth of stromal invasion than the patients in the 5mm group after operation, there was no statistically significant difference (P > 0.05). Cut edge positive group, positive margin group and interstitial fiber positive margin group of patients with postoperative residual disease rates were 25.00%, 15.38% and 23.80%, the difference was not statistically significant (P > 0.05).?Conclusion?The rate of missed diagnosis of small invasive cervical cancer is higher, and the diagnosis rate can be improved by the combination of LEEP and cone resection.

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张阳,王芳.阴道镜活检联合子宫颈环形电刀在宫颈微小浸润癌患者中的应用效果[J].中国内镜杂志,2017,23(3):69-73

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  • 收稿日期:2016-12-08
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  • 在线发布日期: 2017-03-30
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