| 邓勍，古岭梅，古紫云，段文琴，周晓莉，邹冬梅.宫颈CIN患者138例临床治疗方式探讨及疗效分析.[J].中南医学科学杂志.,2012,40(4):400-403. |
| 宫颈CIN患者138例临床治疗方式探讨及疗效分析 |
| The Clinical Analysis of 138 Cases With CIN |
| 投稿时间：2012-05-20 |
| DOI： |
| 中文关键词: 宫颈上皮内瘤变 病理 LEEP 宫颈锥切 |
| 英文关键词:CIN pathology LEEP conization of cervix |
| 基金项目:惠州市科委资助项目（0005685150403020）. |
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| 中文摘要: |
| 目的探讨宫颈上皮内瘤变(CIN)的临床治疗方式，评价宫颈锥切治疗CIN的效果。方法回顾性分析138例CIN患者的临床资料，比较治疗方式、手术前后组织病理变化及术后复发情况，评价诊疗效果。结果138例CIN中， 47例CINⅠ行随访观查及HPV-DNA检测，1年后28例转为CIN阴性，3例升级为CINⅡ，2例升级为CINⅢ，14例维持CINⅠ不变。49例CINⅡ及42例CINⅢ（包括4例原位癌）共91例接受LEEP宫颈锥切诊断治疗，其中64.8%(59/91)术前术后病理完全一致，14.28%(13/91)术后病理降级， 4.4%(4/91)阴性，16.48%(15/91)升级，其中CINⅡ升级至CINⅢ级者11例，重度不典型增生升级为原位癌4例，无1例宫颈癌漏诊。锥切术后继续行全子宫切除15例，其中1例行宫颈癌根治术，随访1年后未见复发。以锥切为最终治疗76例，随访观察1年后发现2例患者(2.63%)再次出现宫颈病变。结论对CINⅠ患者采取密切随访观察，LEEP宫颈锥切能有效诊断和治疗CINⅡ/Ⅲ，根据锥切后病理情况再决定进一步的治疗方案。 |
| 英文摘要: |
| ObjectiveTo explore the best policy for clinical treatment of CIN，and evaluate the therapeutic efficacy of conization of cervix for CIN.MethodsFor 138 cases with CIN who had received follow-up visit and HPV-DNA test ， conization， hysterectomy or radical hysterectomy from 2008 to 2010 year， we retrospectively analyzed the therapeutic efficacy of follow-up visit termination， the different pathologic diagnosis after conization，the recurrence after conization 1 year later.Results138 cases with CIN were diagnosed by biopsy. 47 cases of CINⅠreceived follow-up visit and HPV-DNA test . After 1 year follow-up visit ，28 cases were negative， 5 cases with HPV-DNA had higher grade pathology，14 cases maintain CINⅠ； 49 cases of CINⅡand 42 cases of CINⅢ received conization， among the 91 cases of CINⅡ/Ⅲ after conization， surgical pathology was negative in 4 cases， 15 had higher grade pathology than biopsy in 91cases， 59 cases’ pathology maintain unchanging perioperatively. There were 14 cases received hysterectomy after conization， 1 case received radical hysterectomy. There were 2 recurrent cases in 76 cases with CIN who were treated by conization 1 year later.ConclusionsThe incidence of CIN tends to increase and the patients become younger and younger. The LEEP conization of cervix is of great value in the treatment of CINⅡ/Ⅲ，follow-up visit is the first policy for CINⅠ. |
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