Clinical significance of loop electrosurgical excisional procedure in diagnosis and treatment of cervical adenocarcinoma in situ and invasive cervical adenocarcinoma
10.3760/cma.j.issn.0529-567x.2018.03.007
- VernacularTitle:LEEP术在子宫颈原位腺癌及子宫颈腺癌诊断和治疗中应用的临床意义
- Author:
Yu SONG
1
;
Qing WANG
;
Long SUI
;
Shujun GAO
Author Information
1. 复旦大学附属妇产科医院宫颈疾病诊疗中心
- Keywords:
Uterine cervical neoplasms;
Adenocarcinoma in situ;
Colposcopy;
Electrosurgery
- From:
Chinese Journal of Obstetrics and Gynecology
2018;53(3):178-182
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the accuracy of colposcopic biopsy on diagnosis of cervical adenocarcinoma in situ(AIS)and the clinical significance of loop electrosurgical excisional procedure (LEEP)on diagnosis and treatment of AIS and invasive adenocarcinoma.Methods All medical records of 193 patients diagnosed as AIS by colposcopic biopsy and(or)AIS or invasive adenocarcinoma diagnosed by LEEP conization from Jan. 2015 to Dec. 2016 in Obstetrics and Gynecology Hospital of Fudan University were retrospectively reviewed.The final diagnosis was based on colposcopic biopsy or LEEP or the highest grade of pathological diagnosis after hysterectomy. Results In the 193 patients, 155 cases were finally diagnosed as AIS and 38 cases as invasive adenocarcinoma by histopathologic examination.Among the 155 AIS patients,21.9%(34/155)had positive cone margins,in which 26 patients had hysterectomy,30.8%(8/26) had residual disease in hysterectomy specimens; 78.1%(121/155)had negative cone margins,68 patients with negative margins had hysterectomy and 5.9%(4/68)had residual disease, which was significantly lower than that with positive margins(χ2=10.46, P=0.001). One hundred and twenty from one hundred ninty-three(62.3%,120/193)with AIS were detected by colposcopy.Pathological diagnosis of 50.8%(98/193)cases were upgraded after LEEP conization. Conclusions Colposcopy is indispensable for the diagnosis of AIS, but accurate diagnosis should be made by LEEP. LEEP is capable of detecting AIS or cervical adenocarcinoma that was misdiagnosed by colposcopy, which is a pivotal method for accurate diagnosis. The margin status of LEEP is important for patients in choosing further hysterectomy, but the presence of cervical adenocarcinoma should always be aware of.
