Clinical Analysis Of135Cases Of Cervical Intraepithelial Neoplasia Ⅲ

ObjectiveTo explore the treatment of cervical intraepithelial neoplasia grade III,to contrastprognosis and recurrence about hysterectomy surgery and cervical cold knife conizationsurgery, and to explore whether there is over-treatmentproblems in the treatment of cervicalintraepithelial neoplasia grade Ⅲ.MethodsA retrospective analysis in135cases of patients whose first diagnosed as cervicalintraepithelial neoplasia grade Ⅲ (cervical intraepithelial neoplasia grade Ⅲ involvingglands) of the Second Hospital of Jilin University from January2010to January2011. Aretrospective analysis was done before the examination, preoperative diagnosis,Intraoperative frozen section pathological examination and postoperative pathology results。What we have done is to summarize the number of cervical cold knife conization andhysterectomy,so that we can analyze the reason of doing CKC,and evaluate whether thetreatment consistent with the indications of cervical conization. According to the treatmentguidelines of CKC, Evaluate the the proportion of the cases of compliance and uncompianceof the therapeutic indications.And summarize the the cases of uncompiance of thetherapeutic indications so that we can evaluate whether there are over-treatment.ResultsA total of135cases, there are26cases of CIN Ⅲ diagnosed by cervical biopsies(including3cases complicating uterine fibroids or adenomyosis). Their medical treatments are notcervical conization but directly complete hysterectomy. There are60cases in which the patients underwent cervical biopsy and conization before suffering complete hysterectomy.Weuse the preoperative pathology diagnosis in the highest level as the preoperative diagnosis. Pathological grade of28patients, showed in the pathological examination in cervical conization, have reached the level of CIN Ⅲ, and there are101patients whose pathological grade,showed in the postoperative pathological examination, remains the level of CIN Ⅲ. Comparing the pathology diagnose basis on the sample from Cervical conization with the postoperative pathologic diagnose, we found the grading transformed in the following situation: thereare eight cases in which the pathological grade upgrade(5.93%); there are101cases in which the grade remain unchanged(74.81%); the downgrade showed in the remaining26cases (19.25%, including21negative cases).According to the surgery indications standards of complete hysterectomy and cervical cryo-scalpel conization, there are109cases in which there are preoperative cervical conization pathological examination in this study. There are60patients(51.11%) suffering complete hysterectomy. Among them, postoperative pathology diagnosis show that: remaining CIN Ⅲ in30cases, CIN Ⅱ grade in6cases, pathological downgrading in16cases11.8%).39cases (28.89%) are carryed out Cervical cryo-scalpel conization.Among them, postoperative pathology diagnosis show that: no lesions residues in11cases,remaining CIN Ⅲ in28cases. It is noted that there is positive results in cutting edge in onlyone case, in which the cutting edge shows negative results.ConclusionThe role of hysterectomy and conization in diagnosis and treatment of cervicalintraepithelial neoplasia (CIN)is very significant. According to degrees of cervicalintraepithelial neoplasia (CIN) lesions, treatment, surgical procedures are not the same.Thereare strict indications in hysterectomy and it is not universal knife treatment of cervicalintraepithelial neoplasia grade Ⅲ. Over-treatments and side-effects exist in usinghysterectomy.over-treatment can cause both physical and psychological damages of patients.The causes of over-treatments include both patients and doctors,and most of which are thewrong views of the cervical intraepithelial neoplasia (CIN).We should improve the medicallevel and choose proper and the special treatment to each cercical disease which can benefitto the the physical and mental health.