国际妇产科学杂志 ›› 2016, Vol. 43 ›› Issue (4): 436-441.

• 综述 • 上一篇    下一篇

宫颈上皮内瘤变诊治的相关研究进展

陈敏,颜建英   

  1. 350001 福州,福建省妇幼保健院妇产科,福建医科大学教学医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2016-08-15 发布日期:2016-08-15
  • 通讯作者: 颜建英

Advances in the Diagnosis and Treatment of Cervical Intraepithelial Neoplasia

CHEN Min,YAN Jian-ying   

  1. Department of Obstetrics and Gynecology,Fujian Maternity and Children Health Hospital,Teaching Hospital of Fujian Medical University,Fuzhou 350001,China
  • Received:1900-01-01 Revised:1900-01-01 Published:2016-08-15 Online:2016-08-15
  • Contact: YAN Jian-ying

摘要: 宫颈上皮内瘤变(CIN)是与宫颈癌密切相关的癌前病变。随着宫颈癌生物学研究的进展和筛查技术的进步,宫颈癌的筛查目标已转变为早期检出高级别CIN并行阻断性治疗。在CIN治疗策略的原则中,首要目的应是预防宫颈癌的发生。目前CIN的诊断仍依靠宫颈细胞学、阴道镜与组织病理学这三阶梯技术(“three step” technique)。治疗方面,推荐期待治疗作为CINⅠ女性的标准治疗。对于CINⅡ与CINⅢ,宫颈环形电切术(LEEP)和激光锥切是推荐的治疗方法。术后主要通过细胞学、人乳头瘤病毒(HPV)检测对低至中度疾病残留及复发风险患者进行随访,对高度疾病残留及复发风险患者,推荐阴道镜随诊。现拟从CIN的诊断、转归、治疗、CIN合并妊娠、CIN治疗后对妊娠结局的影响以及随访等方面进行综述。

Abstract: Cervical intraepithelial neoplasia (CIN) is recognized as a kind of precursor lesion associated with cervical cancer. With the great progresses of cervical cancer biology research and screening techniques, early detection and treatment of high grade CIN has become the goal of prevention of cervical cancer. The major ethical and medical aim of all management options for CIN is the prevention of cervical cancer. To date, the "three-step" technique is still the primary way to detect and diagnose of CIN. For management of CIN, observational management was recommended for women with CINⅠ, whereas treatment of CINⅡ and CINⅢ should be excisional. Both loop electrosurgical excision procedure(LEEP) and laser conisation are accepted standard treatments for these patients. After treatment, cytology and human papillomavirus (HPV) testing are the best post-treatment monitoring for patients with low risk of tumor residue and recurrence, whereas colposcopy is recommended for patients with high risk of tumor residue and recurrence. The aim of this paper is to review the progresses of diagnosis, outcome, management and follow-up plan of CIN.