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目的总结分析宫颈原位癌的诊治情况。方法对我院2000年1月至2007年5月住院治疗的61例原位癌进行回顾性分析。结果61例患者中,30岁以下者10例(16.4%),无任何症状19例(31.1%),接触性阴道出血22例(36.1%)。手术前后病理诊断符合率为67.2%(41/61),不符合率31.1%(19/61)。手术方式:宫颈冷刀锥切(CKC)3例,LEEP术5例,宫颈切除6例,全子宫切除±CKC 35例,次广泛子宫切除术11例,其他1例。2例行LEEP术后复发,1例CKC标本切缘发现C INⅠ级。结论宫颈原位癌的确诊应通过宫颈锥切手术,其中阴道镜下宫颈活检起着重要作用。对于年轻的宫颈原位癌可以行单纯的CKC手术治疗,以保留生育功能。对随诊困难、已经绝经及可疑早期浸润癌患者,可行全子宫切除术。
Objective To summarize and analyze the diagnosis and treatment of cervical carcinoma in situ. Methods A retrospective analysis of 61 cases of carcinoma in situ in our hospital from January 2000 to May 2007 was performed. Results Among the 61 patients, 10 (16.4%) were under 30, 19 (31.1%) had no symptoms and 22 (36.1%) had contact vaginal bleeding. The coincidence rate of pathological diagnosis before and after operation was 67.2% (41/61) and the non-coincidence rate was 31.1% (19/61). Surgical methods: 3 cases of cold knife conization (CKC), 5 cases of LEEP, 6 cases of cervical resection, 35 cases of total hysterectomy ± CKC, 11 cases of subtotal hysterectomy and 1 case of other cases. 2 cases of recurrence after LEEP, 1 case of CKC specimens found C INⅠ margin. Conclusion The diagnosis of cervical carcinoma in situ should be performed by conization of the cervix. Cervical biopsy under colposcopy plays an important role. For young cervical carcinoma in situ can be a simple CKC surgery to preserve fertility. Difficult to follow-up, already menopausal and suspicious early invasive cancer patients, feasible hysterectomy.