“即诊即治”宫颈上皮内瘤变43例分析(1)
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【摘要】目的：探讨LEEP刀环形电切术在宫颈病变中的诊断和治疗价值。方法：回顾性分析我院2008年9月至2010年9月，因宫颈病变行宫颈液基薄片细胞学检查、HPV检测及阴道镜下多点活检，多点活检病检阳性率较细胞学检查结果低，随机抽取HPV检测阳性的患者43例，行LEEP刀环形电切术，对比分析TCT、LEEP环切术和阴道镜下多点活检的病理检查结果。结果：43例患者LEEP刀术后病检结果：炎症10例，CINⅠ 7例，CINⅡ 12例，CINⅢ 10例，微小浸润癌4例。LEEP与TCT检查结果符合率LSIL66.67%,HSIL94.44%，各型CIN的高危型HPV阳性例数及阳性率分别为CINⅠ3例，42.85%；CINⅡ 10例，71.43%；CINⅢ 11例，91.67%，癌共4例，100%。结论：当阴道镜下病理结果与TCT不符合时，行LEEP刀环形电切术病检，可提高CIN及早期浸润癌的检出率，特别是高危型HPV感染者。
【关键词】宫颈环形电切术(LEEP术);活组织检查;人乳头瘤病毒(HPV);诊治价值
【中图分类号】R71【文献标识码】B【文章编号】1008-6455(2011)08-0388-02
【Abstract】Objective:To discuss the diagnostic and therapeutic value of cervical loop electrosurgical excision procedure (LEEP) in the treatment of cervical lesions. Methods:Retrospectively analyzed the clinical data of 43 patients who had cervical lesions and were diagnosed by liquid-based/thin-layer cytological test、HPV testing and multiple punch biopsy under colposcope but the result of multiple punch biopsy were lower than cytological examination and HPV test positive.Then the patients received LEEP treatment,we comparatively analyzed the TCT、LEEP and the result of multiple punch biopsy under colposcope. Results:The pathologic examination results of 43 patients after LEEP: 10 cases in inflammation, 7 cases in CINⅠ, 12 cases in CINⅡ, 10 cases in CINⅢ,4 cases in Microinvasive carcinoma.LEEP and results of TCT test in line with the rate: 66.67% in LSIL, 94.44% in HSIL, positive cases and positive rates of high-risk HPV in the various types of CIN were 3 cases in CINⅠ(42.85%);10 cases in CINⅡ(71.43%);11 cases in CINⅢ(91.67%);4 cases in carcinoma (100%).Conclusion:When the results of multiple punch biopsy under colposcope were different with TCT tests,do pathologic examination with LEEP can increase the detection rate of CIN and early invasive cervical cancer ,particularly the infection of high-risk HPV.
【Key words】loop electrosurgical excision procedure (LEEP); Biopsy ; Human papilloma virus(HPV); Value of treatment
宫颈癌是妇科最常见的恶性肿瘤，其发生仅次于乳腺癌，位居第二，严重威胁广大妇女的身心健康，尤其在发展中国家。从宫颈癌前病变发展成宫颈癌有一个较长的过程(大约10年)。因此，宫颈癌是一种可预防、可治愈的疾病[1] ......
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