LCT技术结合阴道镜及宫颈锥切治疗CIN并随访临床观察.docVIP

LCT技术结合阴道镜及宫颈锥切治疗CIN并随访临床观察 　　【中图分类号】R713.4【文献标识码】A【文章编号】1005-2720(2009)08-0276-02【摘要】目的：LCT(薄片液基细胞学检查)技术结合宫颈锥切在CIN(宫颈上皮内瘤样病变)的诊断及治疗应用，以及结合阴道镜在CIN治疗后随访的临床观察。结果：LCT发现有不典型细胞(ASCUS)，再行阴道镜检查并取活检，病理发现CIN 2~3级的，患者要求保留子宫的行宫颈锥切。术后4~6个月随访，并行阴道镜复查及取活检，治愈率为98%。术后1年行LCT检查为正常的细胞。结论：LCT技术在宫颈癌筛查方面是很好的手段，特别是发现CIN，结合阴道镜及活检在诊断方面有很大帮助。而宫颈锥切是保全子宫的一种手段，所切的宫颈送病理可以确诊CIN，是治疗CIN很有效的方法。CIN治疗后的随访也很重要。 　　【关键词】LCT；宫颈锥切；CIN；阴道镜 　　 　　【Abstract】Objective：To assess the value of of liquid-based cytologic test(LCT) and cervical conization in the diagnosis and treatment of cervical intraepithelial neoplasia(CIN)，and the clinical value of them with colposcopy in the follow-up after the treatment of CIN.Results：Patients who require to retain the uterus underwent cervical conization when there were atypical squamous cell of unde-termined significance (ASCUS) in the LCT and the result of Pathology is CIN 2~3 after cervical biopsy under Colposcopy.The cure rate is 98% when we did the review of colposcopy and biopsy after 4~6 months of follow-up.Conclusion：Cytologic and human papilloma virus(HPV) examination of cervix are very good technologies，and important screening method for cervical cancer.They are more useful for the diagonosis of cervical lesion with Colposcopy and cervical biopsy.Cervical conization is a means to preserve the uterus.After cervical conization，we can make a definite diagnosis through the pathology and comprehend the marginal states.It is also very effective in the treatment of CIN.Of course，follow-up is also important after CIN treatment. 　　【Key Words】Liquid-based cytologic test；Cervical conization；Cervical intraepithelial neoplasia；Colposcopy 　　 　　CIN为子宫颈上皮内瘤样病变，分为1~3级。宫颈癌的发病率近年来有所上升，且愈发年轻化，早期发现、早期治疗是防范宫颈癌最有效的方法。而发现及治疗CIN是阻断宫颈癌很好的手段，现就我院近年来LCT发现非典型细胞，再结合阴道镜检查并取活检，病理回报是CIN，笔者为CIN 2~3级的病人行宫颈锥切，术后随访，现总结如下： 　　 　　1 资料与方法 　　 　　1.1 研究对象：为门诊就诊的病人随机做LCT检查，检查前48h内阴道内不放药、不冲洗、不同房。取材的时候，刷子要伸进宫颈管内，转动5圈左右，力度要均匀，避免损伤宫颈组织。把刷子全部放入浸泡液中，送病理科。其中结果回报发现有不典型鳞状上皮细胞(ASCUS)的病人290例，对这290例病例进行常规的阴道镜检