摘要
目的探讨宫颈高度鳞状上皮内瘤变应用"即诊即治"策略的价值。方法选取宫颈细胞学检查为高度鳞状上皮内瘤变(HSIL),并经阴道镜检查、镜下活检及宫颈电圈切除术(LEEP)治疗的患者76例,按阴道镜RCI评分分成高评分组、低评分组,对组织病理结果及过度治疗率进行回顾性分析。结果 RCI高评分组CINⅡ、Ⅲ及以上病变比例为97.4%,低评分组59.5%,高评分组过度治疗率2.6%,低评分组40.5%(P<0.001),不同RCI评分组的过度治疗率差异有统计学意义,高评分组过度治疗率显著低于低评分组。结论对于细胞学为HSIL,经阴道镜检查RCI高评分,提示高度病变的患者,采取"即诊即治"策略快速而有效地进行诊治,是较为适宜的;而细胞学检查HISL、RCI低评分者,仍以传统三阶梯方案进行筛查诊治为宜。
Objective To discuss the value of a ＂see and treat＂ strategy in women with high-grade squamous intraepithelial lesions（HSIL）.Methods A retrospective review was conducted of 76 patients with HSIL who underwent colposcopy,biopsy and cervical loop electrosurgical excision procedure（LEEP）.Patients were divided into high-score group and low-score group based on the RCI score.Final histologicl results and the rate of overtreatment were compared.Results The percentage of CINⅡ Ⅲ and above in RCI high-score group was 97.4%,while in the low-score group was 59.5%.The rates of overtreatment for the RCI high-score and low-score group were 2.6% and 40.5% respectively.The rate of overtreatment was significantly different between the two groups（P〈0.001） and the rate of overtreatment was significantly lower in the RCI high-score group.Conclusion A ＂see-and-treat＂ method may be considered for patients with HSIL cytology and with high score of RCI suggestive of CINⅡ Ⅲ lesions.In contrast,traditional three-step method is still suitable for the screening and treatment.
出处
《实用临床医药杂志》
CAS
2012年第3期53-56,共4页
Journal of Clinical Medicine in Practice
基金
上海市嘉定区卫生局重点学科资助课题(ZD02)
上海市嘉定区卫生局青年科研基金资助项目(QNKYJJ20081106)
关键词
宫颈高度鳞状上皮内瘤变
即诊即治
阴道镜检查
LEEP
high-grade squamous intraepithelial lesion； see-and-treat； colposcopy； loop electrosurgical excision procedure（LEEP）；
