TVRC及CKC对在宫颈重度不典型增生诊治中的评价-肿瘤学专业论文.docxVIP

— — PAGE 1— 摘 要 TCRC 及 CKC 在宫颈 CINⅢ诊治中的评价 研究生：再努尔·阿布都热衣木 导师：丁 岩 摘 要 目的：探讨宫腔镜宫颈锥切术（TCRC）及冷刀锥切术（CKC）在宫颈 CINⅢ诊 治中的临床价值。方法：选择在我院 2005 年 10 月-2007 年 2 月因宫颈 CINⅢ而行 TCRC 术患者 80 例，CKC 术患者 50 例，术前阴道镜多点活检病理与两种手术后病 理诊断对比，术后 3 月、6 月及 12 月随访来评价治愈率，病变持续率，复发率等， 比较两种方法对宫颈 CINⅢ诊治的有效性。结果：两种术后病理诊断与术前阴道镜 病理诊断间符合率对比，TCRC 组符合率 64.28%（51/80），其中 CIN 级别降低者 31.25%（26/80），升级者 3.75%（3/80）。CKC 组术后病检符合率 62%（31/50），其 中 CIN 级别降低者 28%（14/50），升级者 10%（5/50）。采用 x2 检验得：x2=1.0953， P＞0.05，两组之间无统计学意义。TCRC 术治愈率 79.45%，病变持续 12.33%，复 发率 8.22%，切缘阳性率 5%。CKC 治愈率 100% 无病变持续及复发，切缘阳性率 2%。采用 x2 检验得，x2=17.2778，P＜0.05，两组治愈率之间有统计学意义。结合其 治愈率值可知 CKC 术治愈率高于 TCRC 术。结论：CKC 治愈率高，有完整保留组 织学标本，无热传导对病理影响，故对宫颈 CINⅢ，尤其是年轻有生育要求的患者 治疗 CIN 的首选的诊断和治疗方法。TCRC 治愈率低，复发率高，对 CINⅢ慎重选 择。 关键词：宫颈上皮内瘤样病变（CIN）；宫腔镜宫颈锥切术（TCRC）； 冷刀锥切术（CKC） 新疆医科大学医学硕士学位论文 Evaluation of two surgical treatments on diagnosis and treatment of cervical intraepithelial neoplasia Postgraduate:Abdiryim.Zaynuer Tutor:Dingyan Abstract Objective: To evaluate trans cervical conization (TCRC), Cold knife conization (CKC) on diagnosis and treatment of cervical intraepithelial neoplasiaIII. Methods: Specimen of the TCRC, theCKC from october, 2005 to february 2007 were collected, the clinical effect and 80 cases of patients with TCRC, 50 cases of patients with CKC. preoperative colposcopic biopsy on two more post operative pathological diagnosis contrast after operation in 3,6 months and 12months of follow-up to evaluate the cure rate,sustained rate of disease recurrence rates, compared two methods of cervical intraepithelial neoplasiaIII. Results: the two kinds of pathological diagnosis in line with the rate of contrast, TCRC group in line with the rate of 64.28% (51/80), in which 31.25% were CIN downgraded, upgrade were 3.75%, CKC postoperative pathologic examination in line with the rate of 62%. In which CIN were 28% lower level, upgrade of 10%.using x2 test was 1.0953, P0.05, no statistical significance between the two groups. TCRC cure rate of 79.45% patients, lesions sustaine