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目的探讨阴道镜下多点活检与宫颈锥切术后的病检符合率和中、重度子宫颈上皮内瘤变(CIN Ⅱ-Ⅲ)子宫颈锥切术的临床处理方法。方法回顾分析3年多来在阴道镜下活检,病理诊断为CIN Ⅱ-Ⅲ,行宫颈锥切术的患者153例,采用自身对照的方法,对比宫颈锥切术后与阴道镜下多点活检的病理结果。结果宫颈锥切术与阴道镜下活检病理诊断相符者96例,占62.75%;不相符者57例,占37.25%;其中诊断CIN Ⅱ升高为CIN Ⅲ的15例,占9.80%,CIN Ⅲ升为子宫颈浸润癌13例,占8.50%;诊断降低者52例,占33.99%。结论阴道镜检查在诊断宫颈病变中十分重要;宫颈锥切术是一个诊断和治疗双重作用的手术,术后的病理检查尤其重要。CIN Ⅱ-Ⅲ的病例,建议行子宫颈锥形切除术进行最终诊断与治疗。
Objective To investigate the coincidence rate of multi-point biopsy and cervical conization after colposcopy and the clinical treatment of moderate and severe cervical intraepithelial neoplasia (CIN II-III) cervical conization. Methods Retrospective analysis of colposcopic biopsy for more than 3 years, pathological diagnosis of CIN II-III, 153 patients undergoing cervical conization, using self-control method, compared after cervical conization and colposcopic multi-point biopsy Pathological results. Results Ninety-six cases of cervical conization were consistent with pathological diagnosis of colposcopy biopsy, accounting for 62.75%; 57 cases were inconsistent, accounting for 37.25%; of them, 15 cases were diagnosed with CIN II as CIN III, accounting for 9.80%, CIN III Cervical invasive cervical cancer in 13 cases, accounting for 8.50%; 52 cases of reduced diagnosis, accounting for 33.99%. Conclusions Colposcopy is very important in the diagnosis of cervical lesions; cervical conization is a dual-purpose surgery for diagnosis and treatment. Postoperative pathological examination is particularly important. In the case of CIN II-III, cervical cone resection is recommended for final diagnosis and treatment.