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目的:评价宫颈上皮内瘤变(CIN)的不同处理方法及预后。方法:随访2002年6月～2005年6月间在该科宫颈活检病理诊断CIN585例,其中CINⅠ、Ⅱ级分别给予随访观察、物理治疗(微波冷冻)、高频电波刀宫颈电圈切除术(LEEP)、全子宫切除术,CINⅢ级采用LEEP及全子宫切除术,并随访2年。结果:CINⅠ级随访组自然转常率明显低于物理治疗组、LEEP组及全子宫切除组,1年以后复发率高于物理治疗组3倍。CINⅡ级随访组治愈率显著低于物理治疗组和LEEP组,1年以后复发率高于物理治疗组6倍,LEEP组无复发。CINⅢ级采用LEEP及全子宫切除术,均治愈无复发。结论:CINⅠ级可以随访,但物理治疗更加安全可靠。CINⅡ级应选用物理治疗或LEEP治疗,LEEP治疗效果更好。CINⅢ级应采用LEEP及全子宫切除术,希望保留生育功能的年轻妇女可选用LEEP治疗,但需长期随访。
Objective: To evaluate the different treatment and prognosis of cervical intraepithelial neoplasia (CIN). Methods: CIN585 cases were diagnosed by cervical biopsy from June 2002 to June 2005. CIN Ⅰ and Ⅱ were followed up, physical therapy (microwave freezing) and high frequency electrosurgical excision LEEP), hysterectomy, CIN Ⅲ LEEP and hysterectomy, and followed up for 2 years. Results: The spontaneous transfer rate of CIN Ⅰ-level follow-up group was significantly lower than that of physical therapy group, LEEP group and hysterectomy group. The recurrence rate after 1 year was 3 times higher than that of physical therapy group. CIN Ⅱ-level follow-up group, the cure rate was significantly lower than the physical therapy group and the LEEP group, one year later the recurrence rate was higher than the physical therapy group 6 times, LEEP no recurrence. CIN Ⅲ LEEP and hysterectomy, were cured without recurrence. Conclusion: CIN Ⅰ level can be followed up, but the physical therapy is more safe and reliable. CIN Ⅱ level should choose physical therapy or LEEP treatment, LEEP treatment effect is better. CIN Ⅲ LEEP and hysterectomy should be used, hoping to retain fertility in young women may choose LEEP treatment, but long-term follow-up.