Ai zheng = Aizheng = Chinese journal of cancer · 2003
[Evaluation of cold knife conization (CKC) on diagnosis and treatment of cervical intraepithelial neoplasia].
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Zhang Xun, Li Ling, Zhang Wen-Hua, Li Shu-Min
Аннотация
BACKGROUND & OBJECTIVE: Cold knife conization (CKC) is a classic diagnostic and therapeutic procedure. The authors analyzed pathological features of 62 cone specimens and determined the effectiveness of CKC on diagnosis and treatment of cervical intraepithelial neoplasia (CIN).
METHODS: Comparative analysis on pathological findings of cone specimens and multiple biopsies (MB) of 62 CIN patients was performed.
RESULTS: There were close similarities in pathology between CKC and MB in 44 cases (71%). Eighteen cases (29%) showed histological difference between CKC and MB; among them, 4 cases that were given a diagnosis of CIN2 or CIN3 by MB were classified into CIN3 or microinvasive carcinoma by CKC. All 62 cases were squamous epithelial lesions; 34 of them subjected to CIN3 or higher than CIN3. The lesions were mainly located in transformation zone, mostly with cervical canal involvement. Thirty cases showed equal to or more than 2 quadrants involved. Thirty-seven cases (59.7%) had histological evidences for HPV infection. Thirty-one cases(50%) had squamous metaplasia, some with variable dysplasia. Resection margin positive rates were 3.2%(>or=CIN2) and 8.1% (CIN1), respectively, lower than those by loop electrosurgical excision procedure (Leep) reported in literature. Fifty-six cases were closely followed up after operation (4 months-14 years). No recurrences were found and 3 patients had pregnancy and delivery.
CONCLUSION: CKC is significantly effective and cannot be replaced by MB. Squamous metaplasia and CIN development are intrinsically correlated with each other.
METHODS: Comparative analysis on pathological findings of cone specimens and multiple biopsies (MB) of 62 CIN patients was performed.
RESULTS: There were close similarities in pathology between CKC and MB in 44 cases (71%). Eighteen cases (29%) showed histological difference between CKC and MB; among them, 4 cases that were given a diagnosis of CIN2 or CIN3 by MB were classified into CIN3 or microinvasive carcinoma by CKC. All 62 cases were squamous epithelial lesions; 34 of them subjected to CIN3 or higher than CIN3. The lesions were mainly located in transformation zone, mostly with cervical canal involvement. Thirty cases showed equal to or more than 2 quadrants involved. Thirty-seven cases (59.7%) had histological evidences for HPV infection. Thirty-one cases(50%) had squamous metaplasia, some with variable dysplasia. Resection margin positive rates were 3.2%(>or=CIN2) and 8.1% (CIN1), respectively, lower than those by loop electrosurgical excision procedure (Leep) reported in literature. Fifty-six cases were closely followed up after operation (4 months-14 years). No recurrences were found and 3 patients had pregnancy and delivery.
CONCLUSION: CKC is significantly effective and cannot be replaced by MB. Squamous metaplasia and CIN development are intrinsically correlated with each other.