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目的分析宫颈上皮内瘤变采用环形电切术(LEEP)的临床诊治情况。方法分析在北京市密云县妇幼保健院阴道镜下活检确诊为宫颈上皮内瘤变CIN2/3且行LEEP术的192例患者,对比分析LEEP和阴道镜活检的病理结果、HPV感染、切缘阳性及预后的有关因素及术后随访情况。结果 LEEP术前与阴道镜活检病理符合率108/192(56.25%),CIN级别上升35/192(18.23),CIN级别下降49/192(25.52%);切缘阳性26例,其中CIN2 1/78(1.28%),CIN3 23/108(21.30%),宫颈癌早浸2/6(33.33%);192例患者HPV感染180/192(93.75%),对180例患者术后随访中7例病变持续或进展,其中2例切缘阴性,5例切缘阳性均是同HR-HPV持续感染。结论 LEEP术后切缘阳性与病变严重程度及病变残留有关,术后同一HR-HPV持续感染应警惕CIN病变持续存在或进展为宫颈浸润癌。
Objective To analyze the clinical diagnosis and treatment of cervical intraepithelial neoplasia (LEEP). Methods A total of 192 patients with cervical intraepithelial neoplasia (CIN2 / 3) diagnosed as cervical intraepithelial neoplasia undergoing colposcope biopsy in Miyun County Maternal and Child Health Hospital of Beijing were enrolled in this study. Pathological results, HPV infection, positive margins and LEAP were compared between LEEP and colposcopy biopsy. Prognostic factors and postoperative follow-up. Results The preoperative LEEP preoperative colposcopy biopsy coincidence rate of 108/192 (56.25%), CIN grade increased 35/192 (18.23), CIN grade decreased 49/192 (25.52%); positive margins in 26 cases, including CIN2 1 / 78 (1.28%), CIN3 23/108 (21.30%), 2/6 (33.33%) early cervical cancer, 192 (93.75%) of 192 patients were HPV infection, 7 of 180 patients were followed up Lesions continued or progress, including 2 cases of negative margins, 5 cases of positive margins are consistent with HR-HPV infection. Conclusions The positive margins after LEEP are related to the severity of the lesion and the residual of the lesions. After the same HR-HPV persistent infection, the persistence or progression of CIN lesions should be vigilant for cervical invasive carcinoma.