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在 Ablative 治疗前进行结肠镜导向的活检与在患有宫性瘤性HPV的患者中直接 Ablative 治疗相比

Diego Erasun¹, Ana Vazquez Delcampo¹, Alazne DE Castro¹

¹Hospital Universitario Valdecilla, Santander, Spain.

Cancer diagnosis & prognosis

|July 4, 2024

概括

在LLETZ之前,标准的宫癌查协议涉及活检,具有高的假阴性率. 在高风险HPV阳性女性中直接执行LLETZ可以避免错过诊断,但有可能过度治疗低度病变.

科学领域:

妇科妇科医生妇科
在瘤学瘤学.
公共卫生公共卫生

背景情况:

传统的宫癌查涉及结肠镜导向活检,其次是LLETZ用于异常细胞学.
新兴的协议建议在高度可疑或高风险的HPV病例中直接使用LLETZ.
这一转变旨在减少假阴性诊断,但可能会增加过度治疗.

研究的目的:

为了比较宫癌查方案的结果.
评估活检是否可以减少不必要的除性手术,而不会丢失高度病变.
评估直接到LLETZ与活检然后到LLETZ方法的有效性.

主要方法:

对两大高风险HPV妇女队伍的回顾性分析.
在LLETZ之前接受活检的妇女 (n=683) 和直接接受LLETZ的妇女 (n=136) 之间的结果比较.

主要成果:

活检组表现出高的假阴性率,缺少几种高度病变 (CIN3) 和一种侵入性癌症.
直接给LLETZ的组成功检测出所有高度病变.
然而,直接的方法导致过度治疗低度病变.

结论:

在治疗决策中依赖活检结果令人担忧.
两种方案都不是完全令人满意的;直接的LLETZ方法防止了错过的诊断.
需要进一步的研究才能确立准确的诊断,以指导治疗并避免过度治疗.

关键词:

宫的子宫可以这是一个HPVHPVHPV.莱特兹 (LLETZ) 是一个活组织活检科尔波斯科比 (colposcopy) 是一种对体检的方法.

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