| 系统回顾:宫颈环形电切术与冷刀锥切术治疗宫颈上皮内瘤变及宫颈原位腺癌的对 |
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| 引用本文： | 闫德慧,蒋 晶,李佩玲.系统回顾:宫颈环形电切术与冷刀锥切术治疗宫颈上皮内瘤变及宫颈原位腺癌的对[J].现代肿瘤医学,2020,0(16):2909-2912. |
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| 作者姓名： | 闫德慧 蒋 晶 李佩玲 |
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| 作者单位： | 哈尔滨医科大学附属第二医院妇产科，黑龙江 哈尔滨 150081 |
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| 摘 要： | 由于宫颈癌筛查方案的普及，越来越多的宫颈癌前病变及早期宫颈癌得以及时发现及治疗。宫颈环形电切术（loop electrosurgical excisional procedure，LEEP）及冷刀锥切术（cold knife conization，CKC）作为保守手术方案的代表被广泛使用。本文对LEEP与CKC治疗宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN）及宫颈原位腺癌（cervical adenocarcinoma in situ，ACIS）的安全性及有效性进行多方面对比，得出以下结果:对于CIN，LEEP虽然较CKC有着更高的术后复发率，但是在手术时间、术中及术后出血量、住院时间、术后感染率、宫颈管狭窄以及阴道镜检查不满意比例等方面有着明显的优势；对于ACIS，LEEP的切缘阳性率显著高于CKC，二者残留病率及复发率无明显差异；考虑到长期并发症，LEEP较CKC有着早产风险低的优势。总之，根据参考文献，LEEP与CKC均为治疗CIN以及ACIS的安全且有效的手段。对于年轻有生育要求患者，LEEP可能是更好的选择，但需术后严密随访。
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| 关 键 词： | 宫颈环形电切术 冷刀锥切术 宫颈上皮内瘤变 宫颈原位腺癌 |
A systematic review:Comparison of cold knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia and cervical adenocarcinoma in situ |
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| Yan Dehui,Jiang Jing,Li Peiling.A systematic review:Comparison of cold knife conization versus loop electrosurgical excision procedure for cervical intraepithelial neoplasia and cervical adenocarcinoma in situ[J].Journal of Modern Oncology,2020,0(16):2909-2912. |
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| Authors: | Yan Dehui Jiang Jing Li Peiling |
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| Affiliation: | Department of Gynecology，the Second Affiliated Hospital of Harbin Medical University，Heilongjiang Harbin 150081，China． |
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| Abstract: | Because of the popularity of cervical cancer screening program,more and more cervical precancerous lesions and early cervical cancer can be found and treated timely.Loop electrosurgical excision procedure (LEEP) and cold knife conization (CKC) are widely used as representatives of conservative surgical procedures.The safety and efficacy of LEEP and CKC in the treatment of cervical intraepithelial neoplasia and cervical adenocarcinoma in situ were compared in this paper,and the results showed that:for CIN,LEEP had a higher postoperative recurrence rate than CKC,but it had obvious advantages in operation time,intraoperative and postoperative bleeding,time of hospitalization,postoperative infection rate,cervical stenosis,and dissatisfaction of colposcopy.For ACIS,the positive margin of LEEP was significantly higher than that of CKC,and there was no significant difference in the residual disease rate and recurrence rate between the two procedures.Considering the long-term complications,LEEP had the advantage of low risk of premature delivery compared with CKC.Above all,according to the references,LEEP and CKC are both safe and effective methods for the treatment of CIN and ACIS.For young patients or those with fertility requirements,LEEP may be a better choice,but close follow-up is required. |
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| Keywords: | loop electrosurgical excision procedure cold knife conization cervical intraepithelial neoplasia cervical adenocarcinoma in situ |
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