Clinical Analysis On Treatment Of High Grade Cervical Intraepithlial Neoplasia By LEEP And CKC

Backgrounds andObjectivesAt present,cervical cancer is a commom malignancy in china.it’s incidence is getting higher and higher,especially in low-and middle-income countries,and it is younger.Cervical intraepithelial neoplasia as a precancerous lesion of cervical cancer,especially high-grade intraepithelial neoplasia of the cervix,which progresses to cervical cancer for several years,even decades,is most closely related to cervical cancer,and now people are prevented Under the general environment of the main and early diagnosis and early treatment,people are paying more and more attention.Early detection,early diagnosis and early treatment of high-grade cervical intraepithelial neoplasia can reduce the incidence and mortality of cervical cancer.At present,cervical conization is one of the main ways to treat high-grade cervical intraepithelial neoplasia,which can achieve the dual purposes of diagnosis and treatment.It is mainly divided into cervical ring electrotomy and cervical cold knife conization.This study retrospectively analyzed 173 patients with high-grade intraepithelial neoplasia treated by cervical ring electrotomy and cold knife conization,and compared the clinical efficacy of two different surgical methods for the treatment of high-grade intraepithelial neoplasia.MethodA retrospective study was conducted on 173 patients with gynecological gynecology diagnosed as high-grade intraepithelial neoplasia(CIN)of the cervix from June 2014 to June 2016.The patients were divided according to the different treatment methods.Cervical ring-cutting group(LEEP group)and cervical cold-knife cutting group(CKC group),including 93 in LEEP group and 80 in CKC group.The intraoperative conditions,curative effect and postoperative complications were compared between the two groups,including:operation time,intraoperative blood loss,tissue volume after conization,postoperative pathological return margin,postoperative cervical stenosis and adhesion Rate,postoperative surgical stump bleeding rate,postoperative CIN recurrence rate,preoperative and postoperative pathological diagnosis accuracy andpostoperative recovery.Result1.Comparison of operation time and intraoperative blood loss in each group:operation time in the LEEP group(9.2±4.3)minutes,intraoperative blood loss(7.6±3.1)ml,significantly less than the operation time of the CKC group(34.6±10.8)minutes The intraoperative blood loss(22.8±28.0)ml was statistically significant(time t=2.319,P<0.05,intraoperative bleeding t=2.738,P<0.05);2.Intraoperative conical resection of cervical tissue size:LEEP group conical tissue area 4.30 ± 1.41cm2,cone height 1.31 ± 0.32cm;CKC group conical tissue area 5.05 ± 1.45cm2,cone height 2.01 ± 0.42cm,two The difference between the cone cutting area and the cone height was statistically significant(area t=1.712,P<0.05,cone height t=1.665,P<0.05);3.Comparison of postoperative complications between the two groups:3 cases of postoperative bleeding in the LEEP group,4 cases of postoperative infection,no cervical adhesions;4 cases of postoperative bleeding in the CKC group,1 case of cervical adhesions,and 3 cases of postoperative infection.The total postoperative complication rate was 7.53%(7/80)in the LEEP group and 10.0%(8/80)in the CKC group.There was barely noticeable differenceamong the two groups(X2=1.200,P=0.2733);4.Comparison of pathological coincidence rate between the two groups:51 cases of preoperative and postoperative pathology in the LEEP group,accounting for 54.84%(51/93)of the total number of cases in the group.The CKC group was consistent with postoperative pathology.There were 44 cases,accounting for 55.00%(44/80)of all cases in the group;15 cases of postoperative pathology increased in the LEEP group,accounting for 16.13%ofall cases in the group(15/93),the number of postoperative pathological grades in the CKC group was 14 cases,accounting for 17.50%(14/80).The postoperative pathology of the LEEP group was 27 cases,which accounted for 29.03%of the total number of cases(17/93),the number of postoperative grade declines in the CKC group was 22,accounting for 27.50%(22/80)of the total.There were barely noticeable differences in the number of cases between the two groups(consensus X2=0.0004519,P=0.9830;ascending X2=0.05793,P=0.8098;decreased X2=0.04974,P=0.8253);5.Comparison of the margins of the specimens after cervical conization:In the LEEP group,3 cases(3.23%,3/93)were positive for the margin after conization;in the CKC group,the margins were positive after the conization 0 cases(0%,0/80),the difference between the two groups,the difference was not statistically significant(P＝0.2499);6.Comparison of residual or recurrence of lesions after cervical conization:two groups of patients were followed up for 24 months,6 patients(6.45%,6/93)with residual disease or recurrence in the LEEP group;There were 5 cases(6.25%,4/80)with recurrence.There was barely noticeable difference among the two groups(X2=0.002936,P=0.9568).7.Relationship between persistent high-risk HPV infection and residual or recurrence of cervical conization:8 patients with high-risk HPV persistent infection(72.73%,8/11)in patients with residual or recurrence after conization Only 6 patients with persistent high-risk HPV infection(3.70%;6/162)were excluded from the study.The difference was statistically significant(X2=57.03,P<0.0001).8.Cervical cancer and treatment after cervical conization:In the LEEP group,4 patients(4.30%,4/93)who reported cervical microinvasive carcinoma were recalled.All patients underwent hysterectomy.Normal;in the CKC group,4 patients(5%,4/80)who reported microinvasive carcinoma were all recalled.All patients underwent hysterectomy.All follow-up were normal.There was barely noticeable difference among the two groups(X2=0.02097,P=0.8849).in conclusion1、cervical ring electric resection and cervical cold knife conization for the treatment of high-grade cervical intraepithelial neoplasia are basically similar;2、cervical ring electrotomy,simple operation,short operation time,less intraoperative blood loss,resulting in less pain for the patient,easy to be accepted;3、continuous infection of high-risk HP V after cervical conization is a risk factor for residual or recurrence of cervical lesions.