The Clinical Diagnosis And Treatment Of67Cases Of Cervical Intraepithelial Neoplasia Grade Ⅲ (CIN3)

Objective：To evaluate the value of thinprep cytologic test (TCT)，humanpapillomavirus(H PV) test,and colposcopic multiple biopsies in diagnosis of cervicalintraepithelial neoplasia(CIN3).To explore the best treatment of CIN3and in order tobetter guide the clinical diagnosis and treatment.Methods: This retrospective study was performed in67patients with CIN3whowere treated by surgery in the Second Affiliated Hospital of Dalian Medical UniversityDepartment of Obstetrics and gynecology from2005January to2010December forcervical cold knife conization or hysterectomy. All the patients had thinprep cytologictest, human papillomavir us test, colposcopic multiple biopsies, and colposcopyexamination confirmed the diagnosis of CIN3.53patients underwent cervical cold knifeconization,14patients underwent total hysterectomy.Results：67cases of Thinprep cytologic test results: There were25(37.31%) casesof HSIL,13cases (19.40%) of LSIL,6cases (8.96%) of ASC-H,18cases (26.87%) ofASC-US,5cases (7.16%) of NILM.67cases of Human papillomavirus test results:58cases (88.06%), positive and9cases (11.94%) negative. Colposcope examinationresults:7cases (10.45%) of CIN2,60cases (89.55%) of CIN3.53cases cervical coldknife cut method pathology results: there were47cases (88.68%) confirmed CIN3;1case (1.89%) postoperative pathologic reversion of CIN1;1case (1.89%), postoperativepathologic reversion for CIN2;4cases (7.54%) postoperative pathology escalated intoearly invasive carcinoma;6patients (11.32%) had positive margins (CIN3residues).14cases of total hysterectomy pathology results:11cases (78.57%) still exist CIN3lesions;1case (7.14%) postoperative pathologic reversion for CIN2;2cases (14.29%)postoperative pathological upgraded to early invasive carcinoma. Postoperativepathology in67patients,58cases (86.57%) still exist CIN3lesions;3cases (4.48%),postoperative pathological downgraded: reduced to CIN1,1case (1.49%); In2cases (2.99%) reduced to CIN2;6cases (8.95%) postoperative pathology escalated into earlyinvasive.Conclusion：Cytology, colposcopy and pathological examination are the mainmethods for the diagnosis of CIN3, and combination can improve the detection ofCIN3.Hysterectomy should not be used as a treatment primary or original for CIN3.Cervical cold knife conization can be used as diagnosis and treatment, which canprevent excessive treatment, but also can avoid the insufficient treatment, therefor,it isthe first choice of treatment for CIN3.