宫颈锥切术后及阴道镜下活检对宫颈上皮内瘤变诊断价值探析.doc

宫颈锥切术后及阴道镜下活检对宫颈上皮内瘤变诊断价值探析[摘要] 目的：探讨宫颈锥切术后病理检查和阴道镜下活检在诊断宫颈上皮内瘤变(CIN)中的价值。方法：对101例阴道镜活检诊断为CIN的患者行宫颈锥切术,对比手术前后的病理结果。结果：13例阴道镜活检病理为CINⅠ级病例中，9例与宫颈锥切术病理相符，3例宫颈锥切术后病理级别上升，1例病理级别下降；46例阴道镜活检病理CINⅡ级病例中，27例与宫颈锥切病理相符，7例宫颈锥切病理级别上升，12例病理级别下降；42例阴道镜活检病理为CINⅢ级病例中，25例与宫颈锥切病理相符，7例宫颈锥切病理级别上升，10例病理级别下降。结论：阴道镜下活检是诊断CIN的一种简单而有效的方法，宫颈锥切术可以弥补阴道镜下活检的缺陷，且有治疗作用。 [关键词] 宫颈锥切术；阴道镜；宫颈上皮内瘤变 [中图分类号] R711.74 [文献标识码]B[文章编号]1673-7210（2008）10（b）-167-02 Diagnostic value of conization of cervix and pathologic histology with vaginoscope in diagnosing cervical intraepithelial neoplasia YANG Jie-ping (Guangzhou Women and Children’s Medical Center, Guangzhou510180, China) [Abstract] Objective: To compare the diagnostic value of conization of cervix and pathologic histology with vaginoscope in diagnosing cervical intraepithelial neoplasia(CIN). Methods: 101 patients who were diagnosed CIN with pathologic histology with vaginoscope were operated on conization of cervix, and compared the pathologic results before and after the operation. Results: Within 13 cases of CINⅠdegree diagnosed of pathologic histology with vaginoscope, 9 cases were coincident with the result of conization of cervix, the pathologic degree of 3 cases increased after the operation and 1 case decreased; within 46 cases of CINⅡ degree diagnosed of pathologic histologh with vaginoscope, 27 cases were coincident with the result of coization of cervix, the pathologic degree of 7 cases increased after the operation and 10 cases decreased. Conclusion: Pathologic histology with vaginoscope is a simple and effective method for diagnosing CIN, conization of cervix can remedy the defect of the pathologic histology with vaginoscope and shows a therapeutical effect. [Key words] Conization of cervix; Vaginoscope; Cervical intraepithelial neopliasia 近年来宫颈上皮内瘤变(cervical intraepithelial neoplasm, CIN)的发病率呈逐年上升趋势，且趋于年轻化。CIN有发展为宫颈浸润癌的可能，故需早期诊断和治疗。阴道镜下多点活检及宫颈锥切术[包括冷刀和电圈环切术（LEEP术)]已广泛应用于妇产科进行宫颈癌前病变的早期诊断。本文就我科101例阴道镜下多点活检为CINⅠ～Ⅲ级的患者行宫颈