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| Comparison of loop electrosurgical excision procedure and cold knife conization in the treatment of cervical intraepithelial neoplasia 2-3 |
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WANG Ning-ning1， HUA Mao-fang2 |
| (1. Department of Gynecology, the First People′s Hospital, Lianyungang Jiangsu 222000; 2. Department of Gynecology and Obstetrics, Lianyungang Maternal and Child Health Hospital, Lianyungang Jiangsu 222000, China) |
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Abstract Objective: To evaluate the clinical effects of cold knife conization (CKC) and loop electrosurgical excision procedure(LEEP) in the treatment of cervical intraepithelial neoplasia 2-3(CIN2-3). Methods: A retrospective analysis of the clinical data was carried out in 172 cases with CIN 2-3. The clinical effects of CKC and LEEP on the treatment of CIN 2-3 were compared and evaluated. Results: Compared with the CKC group, the LEEP group had shorter operation time, less average intraoperative blood loss, lower rate of postoperative bleeding and cervical adhesion, higher postoperative recurrent rate, and lower risk HPV clearance rate after operation (both P<0.05). Although the rate of residual disease after operation in CKC group was lower than that in the LEEP group, the difference was not statistically significant(P>0.05).Postoperative pathology showed the relapsed patients in the LEEP group were all CIN 3, 80% samples of multi quadrant involvement, residual lesions accounted for 60%. Conclusion: LEEP was super selection to CKC with fewer blood loss, shorter operation time, and fewer postoperative complications; but LEEP was inferior to CKC in reducing recurrent rate(especially in high grade lesion level, specimen with multi quadrant involvement), and persistent high-risk HPV infection.So CKC still couldn't be replaced completely by LEEP.
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Received: 22 May 2014
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| [1]谢幸，苟文丽.妇产科学\[M\]. 8版.北京：人民卫生出版社，2013：301-304.［2］张志毅，章文华.现代妇科肿瘤外科学\[M\].北京：科学出版社，2003：78.［3］干晓琴，张凌，林海，等.冷刀锥切术或LeeP术治疗164例CIN 2~3的临床分析\[J\].四川医学，2010，31(5)：558-560.［4］Hoffman MS, Matrino MA. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia\[J\]. Am J Obstet Gynecol, 2004, 191 (3): 1049.［5］马利国，李明娥，谢红，等.两种宫颈锥切方法治疗宫颈上皮内瘤变Ⅲ级的临床疗效评价\[J\].实用妇产科杂志，2010，26(2)：118-120.［6］连丽娟，林巧稚.妇科肿瘤学\[M\]. 4版.北京：人民卫生出版社，2006：335.［7］Huang LW, Hwang JL. A comparison between loop electrosurgical excision procedure and cold knife conization for treatment of cervical dysplasia: residual disease in asubsequent hysterectomyspecimen\[J\]. Gynecol Oncol, 1999, 73(1): 12-15.［8］Siriaree S, Srisomboon J, Kietpaerakool C, et al. High-grade squamous intraepithelial lesion with endocervical cone margin involvement after cervical loop electrosurgicalexcision: what should aclinician do?\[J\]. Asian Pac J Cancer Prev, 2006, 7(3)：463-466．［9］郎景和.子宫颈上皮内瘤变的诊断与治疗\[J\].中华妇产科杂志，200l，36(5)：261-263．［10］朱鹃，卞美璐，孙霭萍，等.宫颈锥切术在子宫颈病变诊治中的应用\[J\].中日友好医院学报，2011，25(2)：67-70. |
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2014, Vol. 24 
