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[目的]宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)是宫颈癌的癌前病变。近年来,越来越多的年轻女性被诊断出CIN,如何正确而适度的处理CIN是临床处理的目标。本文通过对宫颈上皮内瘤变患者冷刀锥切术(CKC)治疗前后病理情况分析,探讨治疗宫颈上皮内瘤变的合理方式。[方法]对2002年1月～2007年6月间我院收治的132例高度宫颈上皮内瘤变(CINⅡ-Ⅲ)行宫颈锥切术的患者进行回顾性分析。比较手术治疗前后组织病理诊断差异,并随访治疗后复发情况。[结果]132例锥切患者术后病理转阴4例,级别升高10例,其中浸润癌8例。锥切术后继续手术治疗10例,其中4例病理证实有病灶。锥切术后未再治疗的CIN患者中,随访中发现4例(3.3%)再次出现宫颈病变。[结论]宫颈锥切是一种能准确诊断宫颈病变并能较好治疗CIN的方法。建议对于CIN患者应尽量先行宫颈锥切,根据锥切后病理情况及患者对保留生育功能的要求再决定进一步的处理方案。
[Objective] Cervical intraepithelial neoplasia (CIN) is a precancerous lesion of cervical cancer. In recent years, more and more young women have been diagnosed with CIN, how to properly and moderately treat CIN is the goal of clinical treatment. In this paper, the pathological changes of patients with cervical intraepithelial neoplasia before and after cold-knife conization (CKC) treatment to explore a reasonable way to treat cervical intraepithelial neoplasia. [Methods] A retrospective analysis was performed on 132 patients with high grade cervical intraepithelial neoplasia (CINⅡ-Ⅲ) who underwent cervical conization in our hospital from January 2002 to June 2007. The difference of histopathological diagnosis before and after operation was compared and the recurrence after treatment was observed. [Results] In the 132 cases of conization, the pathology changed negatively in 4 cases, the grade increased in 10 cases, including 8 cases of invasive carcinoma. Conectomy continued surgery in 10 cases, of which 4 cases confirmed lesions. Cervical lesions were found again in 4 (3.3%) of the patients with untreated CIN after conization. [Conclusion] Cervical conization is a method that can accurately diagnose cervical lesions and treat CIN well. Recommendations for CIN patients should try first conization of the cervix, according to the post-conization pathology and patient retention of reproductive function requirements and then decide on further treatment options.