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目的分析宫颈上皮内瘤样病变(CIN)患者手术前经阴道镜下多点活检组织学诊断及手术后的组织学诊断符合情况,探讨高频电刀(LEEP)诊断CIN的价值及相关因素。方法选择术前经阴道镜下活检及接受高频电刀手术后组织学诊断为CIN患者116例的结果进行分析研究。结果116例中手术前后病理诊断符合51例,符合率占43.9%,不符合率占56.0%;其中病理分级升高9例,占7.7%;诊断为宫颈浸润癌4例,占3.4%;分级下降59例,占50.8%;绝经前患者诊断符合率47.3%,绝经后患者诊断符合率36.3%;有临床症状的患者诊断符合率57.6%,无临床症状的患者诊断符合率为32.2%。结论应用高频电刀诊断及治疗CIN有一定的临床价值,诊断CIN分级的准确性与患者绝经与否、阴道镜多点活检,术前CIN分级无明显相关性,与患者有无临床表现有明确相关。因此,阴道镜诊断为CIN的患者,包括浸润癌或者CIN患者不能定期随诊者,应行高频电刀蘑菇切或锥切,以进一步明确诊断与治疗,尽量避免过度治疗以及漏诊。
Objective To analyze the histopathological diagnosis of cervical intraepithelial neoplasia (CIN) by multi-point biopsy before operation and the histological diagnosis after operation. To explore the value and related factors of high-frequency electric knife (LEEP) in diagnosis of CIN. Methods The results of 116 patients with CIN who underwent colposcopic biopsy and histological examination after high frequency electrosurgical surgery were analyzed. Results The pathological diagnosis of 116 cases was consistent with 51 cases, the coincidence rate was 43.9% and the non-coincidence rate was 56.0%. The pathological grade was increased in 9 cases (7.7%), and the diagnosis of cervical invasive carcinoma was in 4 cases (3.4%). 59 cases decreased, accounting for 50.8%. The coincidence rate of premenopausal patients was 47.3%, and that of postmenopausal patients was 36.3%. The coincidence rate of 57.6% of patients with clinical symptoms and 32.2% of patients without clinical symptoms. Conclusion The diagnosis and treatment of CIN with high-frequency electric knife has certain clinical value. The accuracy of diagnosing CIN grade has no significant correlation with the clinical stage of menopause, colposcopy biopsy, preoperative CIN classification, and clinical manifestations Clearly related. Therefore, colposcopic diagnosis of CIN patients, including invasive cancer or CIN patients can not be followed up regularly, should be high-frequency electric knife mushroom or conization to further confirm the diagnosis and treatment, as far as possible to avoid over-treatment and missed diagnosis.