發(fā)布時(shí)間：2018-01-30 22:16

  本文關(guān)鍵詞： 陰道鏡活檢 LEEP刀 宮頸微小浸潤(rùn)癌 診斷　出處：《中國(guó)內(nèi)鏡雜志》2017年03期 　論文類型：期刊論文

【摘要】：目的探究陰道鏡活檢聯(lián)合子宮頸環(huán)形電刀(LEEP刀)錐切術(shù)在宮頸微小浸潤(rùn)癌患者中的應(yīng)用效果。方法回顧性分析2013年6月-2016年6月該院經(jīng)LEEP錐切術(shù)診斷為微小浸潤(rùn)癌的66例患者的臨床資料。術(shù)前66例患者均經(jīng)陰道鏡活檢,比較陰道鏡活檢與LEEP錐切術(shù)對(duì)微小浸潤(rùn)癌診斷的情況,不同間質(zhì)浸潤(rùn)深度和切緣情況患者LEEP錐切術(shù)后病變殘留情況。結(jié)果陰道鏡活檢檢出2例輕度鱗狀細(xì)胞上皮內(nèi)瘤變(LSIL)、60例重度鱗狀上皮內(nèi)瘤變(HSIL)、1例宮頸原位腺癌(AIS),3例患者診斷為子宮頸微小浸潤(rùn)癌或可疑子宮頸微小浸潤(rùn)癌,敏感度為4.54%,漏診率為95.46%;LEEP錐切術(shù)檢出1例LSIL、44例HSIL、1例AIS,20例切緣陰性。3組患者LEEP錐切術(shù)切除組織的厚度和面積差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。微小浸潤(rùn)癌組患者切除組織的深度明顯高于HSIL及AIS組,HSIL及AIS組患者切除組織的深度高于LSIL組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。間質(zhì)浸潤(rùn)深度≤1 mm組、1 mm間質(zhì)浸潤(rùn)深度≤3 mm組和3 mm間質(zhì)浸潤(rùn)深度≤5 mm組患者的術(shù)后病變殘留率分別為15.00%、19.51%和20.00%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。內(nèi)切緣陽(yáng)性組、外切緣陽(yáng)性組和纖維間質(zhì)切緣陽(yáng)性組患者的術(shù)后病變殘留率分別為25.00%、15.38%和23.80%,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論單純陰道鏡活檢診斷子宮頸微小浸潤(rùn)癌漏診率較高,聯(lián)合LEEP錐切術(shù)診斷能夠提高診斷率。
[Abstract]:Objective to explore the combination of colposcopy biopsy and cervix ring electric knife (LEEP). Clinical data of 66 patients with microinvasive carcinoma of the cervix diagnosed by LEEP conization from June 2013 to June 2016 were retrospectively analyzed. Materials. All the 66 patients underwent colposcopy biopsy before operation. To compare the diagnosis of microinvasive carcinoma with colposcopy biopsy and LEEP conization. Results 2 cases of mild squamous cell intraepithelial neoplasia were detected by colposcopy biopsy. 60 cases of severe squamous intraepithelial neoplasia (HSILN) and 1 case of in situ adenocarcinoma of cervix were diagnosed as small invasive carcinoma of the cervix or suspected small invasive carcinoma of the cervix with a sensitivity of 4.54%. The missed diagnosis rate was 95.46; One case of LSILA was detected by LEEP conization in 44 cases with HSILA and 1 case with AIS. There was no significant difference in the thickness and area of tissue resected by LEEP conization in 20 patients with negative margin (P 0.05). The depth of resected tissue in patients with microinvasive carcinoma was significantly higher than that in HSIL and AIS groups. The depth of resected tissue in HSIL and AIS group was higher than that in LSIL group, the difference was statistically significant (P 0.05). The interstitial infiltration depth 鈮，

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