| Objective To evaluate the value of cervix conization in diagnosis and management of high grade cervical intraepithelial neoplasia (CIN) and micro invasive carcinoma of cervix (MIC). Methods 124 cases with high-grade cervical intraepithelial neoplasia and micro invasive carcinoma of cervix diagnosed by colposcopic multiple biopsies at the affiliated hospital of Ningxia Medical University from June 2005 to January 2010,who accepted operation treatment. Datas were retrospectively reviewed including patients,age,breeding status, Gynecological examination (cytologiecal examination and/or high-risk HPV test),biopsy histological result,operative time,blood loss and postopertative pathology etc. We analyzed retrospectively focusing on the comparative study in pathology among preoperative colposcopic multiple biopsies, intraoperative frozen section examination, postoperative tissue examination results and the choice of treatment methods. Results①(12.59±2.80min) (p<0.05); The blooding during operation in CKC (47.60±18.90ml) group was significantly more than in LEEP (13.25±3.80ml) group. There was highly statistic significance (p<0.05).②The average time patients stay in hospital for observation of LEEP(0.022±0.005d) was shorter than that of CKC (3.440±0.507d) (P<0.05), The average healing time of cervical of LEEP (25.266±4.596d) was shorter than that of CKC(30.480±4.909d) ( P<0.05), There was highly statistic significance.③There 3/43 cases of CKC which cervix net margin is not were underwent total hysterectomy or expanded operations; 9/81 cases of LEEP were underwent the second conization , and 11/81 cases were cope with total hysterectomy or expanded operations, compared with the two groups , There was highly statistic significance (p<0.05). ④A comparison between conization pathology and colposcopy biopsy of multi-point: total of 124 cases were accord,including 33(26.61%) severe cases and 22(17.74%) mild cases of cervical lesions in conization pathology than that of colposcopy biopsy of multi-point. The diagnose accordance rate of CINⅡand CINⅢwere 25%(5/20) and 63.73%(64/101) respectively. The diagnose accordance rate of conization pathology and colposcopy biopsy of multi- point was higher in group CINⅢthan that of group CINⅡ(p<0.05). There was highly statistic significance.⑤The result of 23 cases which compared the pathology of cervical conization to the pathology after hysterectomy is thatχ2=0.549,P=0.459>0.05. There was no statistic significance.⑥Changes in before and after cervical conization:25 cases HPV testing suggest 22cases is HPV (+),the positive rate was 88%;3cases is HPV (-), the negative rate was 12%.The RLU/CO of HPV-DNA in CINⅡand CINⅢafter cervical conization were lower than that of before cervical conization, (P<0.05), There was highly statistic significance.⑦Postoperative follow-up: the time was 5 years which was the longest, and 1 year which was the shortest; 1 year recurrence rate wre 10%, 3.13%and 5.88%; there were no recurrence in 2, 3, and 5 year. Conclusions①Cervical conization is the preferred methods which can treatment high grade cervical intraepithelial neoplasia, and also feasible with young women who require fertility;②Conization may be effective in clearing HPV infection by the resection of lesions;③After cervical conization, the incidence of residual disease is lower and also Relapse rate... |
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