本文選題：二次活檢　切入點(diǎn)：宮頸錐切術(shù)　出處：《西安交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)》2017年01期

【摘要】：目的探討二次活檢—宮頸錐切術(shù)在子宮頸病變?cè)\治中的臨床價(jià)值及應(yīng)用指征。方法選取濟(jì)南軍區(qū)總醫(yī)院婦科2012.01-2015.10間行宮頸多點(diǎn)活檢病理為子宮頸癌IA期及以下、采用宮頸環(huán)形電切(LEEP)術(shù)行宮頸錐切二次活檢的413例患者的病例資料進(jìn)行回顧性分析。結(jié)果與宮頸多點(diǎn)活檢比較,約10.65%(44/413)錐切術(shù)后發(fā)生病理升級(jí),73.37%(303/413)一致,15.98%(66/413)逆轉(zhuǎn)(病理級(jí)別下降和轉(zhuǎn)陰)。宮頸多點(diǎn)活檢與二次活檢—宮頸錐切術(shù)在診斷宮頸低級(jí)別上皮內(nèi)病變、高級(jí)別上皮內(nèi)病變、早期浸潤(rùn)癌(IA期)方面差異有統(tǒng)計(jì)學(xué)意義(T=21.740,v=3-1=2,P0.05)。錐切前高危型人乳頭瘤病毒(HPV)感染的陽(yáng)性率為71.91%(297/413);錐切后病理升級(jí)的高危型HPV感染陽(yáng)性率為86.36%(38/44),未升級(jí)的為70.20%(259/369)。錐切前液基薄層細(xì)胞學(xué)(TCT)檢查陽(yáng)性(ASC-US及以上)為87.89%(363/413),其中11.85%(43/363)錐切后病理升級(jí)。對(duì)錐切后病理升級(jí)與未升級(jí)的宮頸病變的高危型HPV感染陽(yáng)性率、TCT檢測(cè)陽(yáng)性率比較,差異均有統(tǒng)計(jì)學(xué)意義(χ2=5.092,P0.05;χ2=4.476,P0.05)。結(jié)論二次活檢—宮頸錐切術(shù)作為宮頸多點(diǎn)活檢術(shù)診治宮頸病變的一種再評(píng)價(jià),能顯著提高確診率,減少隱匿性宮頸癌的漏診,但其在臨床應(yīng)用時(shí)有一定的指征。
[Abstract]:Objective to explore the clinical value and indication of double biopsis-cervix conization in the diagnosis and treatment of cervical lesions. Methods Cervical multipoint biopsy was performed in 10 gynecological departments of Jinan military region General Hospital from January 2012.0 to May 2015.The pathology of cervical cancer was IA stage and below. The data of 413 cases of cervical conical biopsy were analyzed retrospectively by means of circular electrosurgical excision of cervix (LEEP). The results were compared with that of multipoint cervical biopsy. About 10.65% 44 / 413) pathological upgrade occurred after conic resection: 73.37 / 303 / 413) 15.98% 66 / 413) reversal (pathological grade decline and negative change. Cervical multipoint biopsy and double biopsis-cervical conization in the diagnosis of cervical low grade intraepithelial lesions, high grade intraepithelial lesions, The positive rate of high risk HPV infection was 71.91 / 4130.The positive rate of high risk HPV infection was 86.366-38 / 444.The unupgraded rate was 70.20p / 3699.The positive rate of high risk HPV infection was 86.3640 / 38 / 44, and the positive rate of high risk HPV infection was 70.20p / 3690.The positive rate of high risk HPV infection was 71.91 / 4137.The positive rate of pathologically upgraded high-risk HPV infection was 86.3640 / 38 / 44, and the unupgraded rate was 70.20p / 3690.The positive rate of high risk type HPV infection was 70.20%. The positive rate of HPV infection was 87.89 / 413% (11.85% / 363). The positive rate of high risk HPV infection after conical resection was compared with that of non-upgraded cervical lesions. The difference was statistically significant (蠂 2 + 5.092 P 0.05; 蠂 2 + 4.476% P 0.05). Conclusion as a re-evaluation of cervical multipoint biopsy, the rate of diagnosis and treatment of occult cervical cancer can be significantly increased, and the missed diagnosis of occult cervical cancer can be reduced. But it has certain indication in clinical application.
【作者單位】： 錦州醫(yī)科大學(xué)濟(jì)南軍區(qū)總醫(yī)院婦產(chǎn)科實(shí)習(xí)基地;濟(jì)南軍區(qū)總醫(yī)院婦科;
【分類號(hào)】：R737.33

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