摘要
目的 了解宫颈原位癌的临床特点及治疗方法，总结不同治疗方法对宫颈癌患者生存、复发、及妊娠的影响。方法 回顾性分析1987年1月至2002年10月行手术治疗的118例宫颈原位癌患者的临床表现、诊断方法、手术方式、病理结果及预后情况。患者的年龄24～77岁，平均38．8岁，宫颈细胞学检查以宫颈上皮内瘤变Ⅲ及宫颈高度鳞状上皮内瘤变为主。118患者接受了阴道镜检查，以多象限的病变为主。全部的患者接受了宫颈锥切手术，手术方式有冷刀锥切和电刀锥切两种。结果 冷刀锥切64例，占54％；电刀锥切54例，占46％。两种方式在病理切净程度、手术并发症等方面差异均无统计学意义。71例（60％）患者接受锥切手术后随诊，47例（40％）患者接受全子宫（或加双附件）切除手术。17例患者宫颈锥切手术后妊娠。随诊118例患者未见有肿瘤的复发。结论 宫颈原位癌的确诊应通过宫颈锥切手术，其中宫颈细胞学检查、阴道镜检查均起着重要作用。对于年轻的宫颈原位癌可以行单纯的宫颈锥切手术治疗，以保留生育功能。对于随诊困难并已经绝经的妇女可以行全子宫双附件切除手术。
Objective To analyze the clinical characteristics and treatment of cervical carcinoma in situ. Methods The clinical data of 118 patients with cervical carcinoma in situ （CIS）, aged 38.8 （24～77）, were retrospectively analyzed. Results Cervical cytology showed that most of the lesions were cervical intraepithelial neoplasm （ CINIII）, high-grade squamous intraepithelial lesion （ HSIL）, or CIS. Most of the patients underwent colposcopic examination. All the patients underwent conization. 54% of the patients were given cold knife conization, and 46% of the patients received electric knife conization. 71 of the patients undergoing conization （60%） were followed-up. Another 40% received total hysterectomy and/or bilateral salpingo-eophorectomy. 17 cases were found pregnant after the conization. There were no differences in pathologically thorough resection and operational complication between the two surgery methods： cold knife conization and electric knife conization. Follow up study showed that conization had no effect on the subsequent pregnancy. Conclusion Conization is necessary for the final diagnosis of cervical carcinoma in situ. Both cervical cytology and colposcopic examination are very important for screening of CINIII or CIS. For the young patients conization suffices, however, for the postmenopausal women or those unable to receive follow-up examination total hysterectomy and bilateral salpingo-eophorectomy should be considered.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第5期300-302,共3页
National Medical Journal of China
