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目的:观察宫颈锥切术对宫颈微小浸润癌的诊断及治疗效果,以探讨宫颈锥切术的临床价值。方法:对60例宫颈微小浸润癌患者宫颈锥切术后病理诊断结果及术前阴道镜活检结果进行比较,并观察患者锥切术后治疗效果及预后。结果:宫颈上皮内瘤变Ⅲ级31例,早期浸润癌29例,其中5例有局部间质浸润,经宫颈锥切术病理确诊宫颈癌Ⅰa1期43例,Ⅰa2期17例;阴道镜活检与锥切术病理诊断符合率为56.67%。宫颈癌Ⅰa1期43例患者中41行全子宫切除或扩大切除术,2例保留子宫并严密随访(2例均于术后第3年妊娠并分娩1次);宫颈癌Ⅰa2期17例患者均行广泛或次广泛子宫切除及盆腔淋巴结清除。结论:宫颈锥切术不仅能有效确诊宫颈微小浸润癌,而且对要求保留生育能力的患者也是一种简单有效的治疗方法。
Objective: To observe the diagnosis and treatment of cervical micro-invasive carcinoma of cervical conization, in order to investigate the clinical value of cervical conization. Methods: The pathologic diagnosis results of 60 cases of cervical micro-invasive carcinoma after cervical conization were compared with the results of preoperative colposcopy biopsy, and the therapeutic effect and prognosis after conization were observed. Results: 31 cases of grade Ⅲ cervical intraepithelial neoplasia, 29 cases of early invasive carcinoma, including 5 cases of local interstitial infiltration, Cervical conization pathological diagnosis of cervical cancer Ⅰ a1 43 cases, Ⅰ a2 17 cases; colposcopy biopsy and The conization rate of conization was 56.67%. Among the 43 patients with stage Ⅰa1 cervical cancer, 41 cases underwent total hysterectomy or extended resection, 2 cases were kept with uterus and closely followed up (both in 3 years postpartum pregnancy and childbirth 1); 17 cases of cervical cancer Ⅰa2 Extensive or sub-extensive hysterectomy and pelvic lymph node dissection. CONCLUSION: Conization of the cervix not only can effectively diagnose microinvasive cervical cancer, but also is a simple and effective treatment for patients who require retention of fertility.