| Objective:To find out a kind of safe and effective treatment method for young ladies who are suffering from cervical carcinoma but still want to keep birth ability through summarizing and analyzing epidemiology material, clinical pathological material and treatment methods of those Cervical Carcinoma patients who attended our hospital for last 3 years.Methods:Analyze epidemiology material, clinical and pathological material of 136 Cervical CINIII cases during the period of 2004-2006. Among the total those hospital patients was Group A, those patients was given LEEP in out-patient clinic was Group B; For CIN patients (Group C) who were Diagnosed in our hospital during the period of 1985-2006, 5-FU injection was given to observe the treatment result and pathologically compare the situation before and after treatments, in the meanwhile. These patients also were closely given following up checks.Results:1. Clinical response: except 8 conization of uterine cervix cases were lack of symptom records on their medical records, the rest 128 cases had subjective symptom:contact bleeding accounts 30.62%,irregular bleeding symptom accounts 18.13%,secretion increase accounts 15.62%,24.38% is absence of symptoms; Check : 25 cases had slight erosion, 57 had heave erosion, 5 had smooth smear surface, 33 had hyperplasia on pathological parts, 23 had changes to post-Conization of Uterine Cervix. 2. Diagnosis methods: 94 cases were directly diagnosed by biopsy, 24 by pathologic after Conization of Uterine Cervix because of Smear erosion,; 18 by cytology, 16 among these 18 cases were identified by biopsy, 1 was diagnosed Smear Infection by biopsy, 1 was not implemented. The compatable rate of biopsy and pathological test post surgery is 60%, 30.9% is better in comparison with biopsy, 9.1% is squamous cancer, 24 cases of LEEP knife Conization of Uterine Cervix were given total hysterectomy or pathologic post operation, 10 of them were clear, 3 were CINIII (12.5%), 1 (4.17%) was microinvasion squamous cancer.3. treatmentGroup A:P athological comparison in pre-operation and post-operation: 24 cases were given generally or deutero- generally abdominal hysterectomy , according to pathological report after operation, 11 of them were CINIII (45.83%), 3 were CIN-II (12.5%), 4 were chronic cervictis without CIN (16.67%), 3 were accompanying infiltration (12.5%). 83 CINIII patients were given total hysterectomy, according to post-operation pathological report, , 37 were CINIII(44.58%), 19 were CINI-II (22.89%), 15 were chronic cervicitis without CIN (18.07%), 12 were accompanying infiltration. 7 CINIII patients were given generally amputation of cervix, according to post-operation pathological report, 5 were CINIII, 2 were chronic cervictis without CIN. 3 CINIII patients were given cold knife conization, according to post-operation pathological report, 1 was CINI-II, 1 was chronic cervicitis without CIN, 1 was accompanying infiltration. 19 patients were given LEEP operation, according to post-operation pathological report, 12 were CINIII, 6 were CINI-II, 1 was chronic cervictis without CIN. Group B:Conization of uterine cervix for CINIII: 22 of patients were given such operation for the purpose of keeping bith ability. According to post-operation pathological report, 15 were CINIII, 1 was accompanying infiltration; 4 were CINI-II, 2 were chronic cervictitis without CIN. The patients were regularly given recheck-ups, for those who were not satisfied with the result of cervical intraepithelial neoplasia and abnormal result of biopsy, the conization of uterine cervix were given again. After the 2nd operation, except 1 patient still had CINI locally, the pathological report indicats that there are no pathological change for the rest patients.'Group C:5-FU partial injection treatment for CIN: there are total 20 patients were purely given 5-FU partial injection treatment since 1985 till now. Among these 20 cases, 11 are CIN I, 6 are CINII, 3 are CINIII. Their ages are ranged 23-48, 31 in average, 7 of them never give a birth. After 4 cycles treatments, most of them are recovered except 2 patients still have CINI.4. Following-up consulting:Group B: For those who were given Conization of Uterine Cervix, recheck ups were curried out once every 2-3 months, the cervical intraepithelial neoplasia test and cervical scraping smear (liquid based cytology) test would be curried out once a year for biopsy.Any potential patients would be given pathological test immediately. And then recheck-ups would be given once every year after 2 years. The follow-up percentage was 100% within a year, 90% within 2 years, 85% within 3 years, no cancer was found. Those who never give a birth before all acquired cyophoria within 1-2 years after stopping taking medicine, and all gave a birth naturally.Group C: For patients recovered after 5-FU injection treatment, recheck-ups such as cervical scraping smear test (liquid based cytology recent years) and cervical intraepithelial neoplasia were given regularly every 4-6 months, biopsy would be given once a year regularly, if there exist any potential patients, the pathological test will be curried out immediately, follow ups will be given regularly once a year after 2 years. The percentage of follow-up is 100% within a year, 78% within 2 years, 64% within 3 years and 34% within 5 years. In 10 years time, the percentage of follow-up is 80%. Those who never give a birth before obtained cyophoria and give birth naturally. Each patient get recheck-ups at least 3 times, no cancer was found in cervical intraepithelial neoplasia test (liquid based cytology test). there is no cancer found within 10 years follow up consulting.Conclusions:1. cytology and histological checking system is improved, and the checking-diagnosis should be standardized. Especially for young patients, LEEP operation should always be curried out at the first place, so that the reliable histological gist can be offered for choosing operation range.2. the treatment plan should be made individually according to patient's age, birth requirement, private choice and follow-up condition. For patients who have no birth requirements or are not suitable for follow-up consulting, total hysterectomyshould be the first and safest choice; for those who have birth requirements and are suitable for follow up consulting, Conization of Uterine Cervix will be the most optimal choice because this method has the advantage of safety, efficiency and time-saving, therefore, it is worth of exploring in further.3. 5-FU injection is a kind of effective and safe treatment for CIN. It helps to stop the cancer process in advance, keep the normal function of smear; moreover, it has no any side-effects. Although it is time-consuming, 5-FU injection method would still be reliable treatment for those reject operation. Hence, it is worth of giving more research in further.4. the cervical intraepithelial neoplasia test , cervical scraping smear and liquid based cytology can offer reliable gist for follow up consulting and Conization of Uterine Cervix treatment.
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