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目的探讨高频电波刀宫颈环形电切除术(Loop electrosurgical excision procedure,LEEP)对宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)Ⅱ～Ⅲ级患者诊断及治疗的临床价值。方法对266例CINⅡ～Ⅲ级患者行LEEP手术治疗,并进行为期2～5年的随访,对阴道镜下多点活检病理结果与LEEP术后标本病理检查结果比较,病变残留和复发等情况进行分析总结。结果 LEEP术后标本病理检查结果有22例CIN级别高于活检病理结果,病理检查不符率为8.27%。6个月总的治愈率为92.97%,1年内病变残留率4.30%,2年复发率为2.34%,3年复发率为0.39%,4、5年无复发。其中CINⅡ164例,6月治愈率97.52%,1年内病变残留率1.24%,2年复发率为1.24%,3、4、5年的复发率均为0。CINⅢ102例,6月治愈率为85.26%,1年内病变残留率9.47%,2年复发率4.21%,3年复发率1.05%,4、5年复发率均为0。CINⅡ与CINⅢ在治愈率、病变残留率方面比较,差异有统计学意义(P<0.05),复发率比较差异无统计学意义(P>0.05)。结论 LEEP在CIN的诊断及治疗中有重要价值,可减少CIN的漏诊;对于CINⅡ～Ⅲ级患者的治疗是安全、有效的;但需长期随访,尤其是术后2年。
Objective To investigate the clinical value of high frequency electrosurgical excision procedure (LEEP) in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN) Ⅱ ~ Ⅲ patients. Methods A total of 266 patients with CINⅡ ~ Ⅲ were enrolled in this study. The patients were followed up for 2 to 5 years. The pathological results of multiple biopsy under colposcopy and LEEP were compared with those of LEEP. analysis Summary. Results The pathological results of LEEP postoperatively showed that 22 cases of CIN were higher than biopsy results and the pathological examination failed rate was 8.27%. The overall cure rate at 6 months was 92.97%. The residual disease rate was 4.30% in 1 year, 2.34% in 2 years, 0.39% in 3 years and no recurrence in 4 and 5 years. The CINⅡ164 cases, the cure rate was 97.52% in June, the residual disease rate in 1 year was 1.24%, the recurrence rate in 2 years was 1.24%, and the recurrence rates in 3, 4 and 5 years were all 0. CINⅢ102 cases, the cure rate in June was 85.26%, the residual disease rate in one year was 9.47%, the recurrence rate in 2 years was 4.21%, the recurrence rate in 3 years was 1.05%, and the recurrence rates in 4 and 5 years were both 0. CIN Ⅱ and CIN Ⅲ in the cure rate, disease residual rate, the difference was statistically significant (P <0.05), the recurrence rate was no significant difference (P> 0.05). Conclusions LEEP is of great value in the diagnosis and treatment of CIN, which can reduce the misdiagnosis of CIN. It is safe and effective for the treatment of CIN Ⅱ ~ Ⅲ patients. However, it needs long-term follow-up, especially after 2 years.