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目的:探讨宫颈环形电切术(LEEP)在诊断、治疗宫颈上皮内瘤变及早期浸润癌中的临床意义。方法:对2008年5月～2010年5月杭州师范学院附属余杭医院收治的182例宫颈上皮内瘤变与宫颈早期浸润癌患者行LEEP术,并分析比较患者预后。结果:行LEEP术后经病理诊断出宫颈炎18例(9.9%);C IN I级40例(22.0%);C INⅡ级74例(40.7%);C INⅢ级27例(14.8%);宫颈原位癌16例(8.8%);宫颈早期浸润癌7例(3.8%)。与术前阴道镜下多点活检与宫颈液基细胞学检查结果比较,一致率为86.8%;升级、降级各占6.6%,两组诊断差异具有统计学意义(P<0.01)。术后的随访显示治愈率97.8%,复发率1.1%,残留率0.5%。结论:LEEP术对宫颈上皮内瘤变及早期浸润癌具有诊断和治疗的双重功能。
Objective: To investigate the clinical significance of cervical ring excision (LEEP) in the diagnosis and treatment of cervical intraepithelial neoplasia and early invasive carcinoma. Methods: From May 2008 to May 2010, 182 cases of cervical intraepithelial neoplasia and early invasive carcinoma of cervix were treated with LEEP in Yuhang Hospital affiliated to Hangzhou Teachers College and the prognosis was analyzed. Results: Pathological diagnosis of cervicitis was performed in 18 cases (9.9%) after LEEP; 40 cases (22.0%) were in CIN I class; 74 cases (40.7%) in CIN II class; 27 cases (14.8% Cervical carcinoma in situ in 16 cases (8.8%); early cervical cancer in 7 cases (3.8%). Compared with preoperative colposcopy biopsy and cervical liquid-based cytology, the concordance rate was 86.8%, and the grade was upgraded or downgraded by 6.6% respectively. The difference between the two groups was statistically significant (P <0.01). Postoperative follow-up showed that the cure rate was 97.8%, the recurrence rate was 1.1% and the residual rate was 0.5%. Conclusions: LEEP has the dual function of diagnosis and treatment of cervical intraepithelial neoplasia and early invasive carcinoma.