锥活组织检查

定义

A cone biopsy (conization) is surgery to remove a sample of abnormal tissue from the 子宫颈. The 子宫颈 is the lower part of the uterus (womb) that opens at the top of the 阴道. Abnormal changes in the cells on the surface of the 子宫颈 is called 宫颈发育不良.

选择的名字

Biopsy - cone; 宫颈锥形切除术; CKC; Cervical intraepithelial neoplasia - cone biopsy; CIN - cone biopsy; Precancerous changes of the 子宫颈 - cone biopsy; 子宫颈癌 - cone biopsy; Squamous intraepithelial lesion - cone biopsy; LSIL - cone biopsy; HSIL - cone biopsy; Low-grade cone biopsy; High-grade cone biopsy; Carcinoma in situ-cone biopsy; CIS - cone biopsy; ASCUS - cone biopsy; Atypical glandular cells - cone biopsy; AGUS - cone biopsy; Atypical squamous cells - cone biopsy; Pap smear - cone biopsy; HPV - cone biopsy; Human papilloma virus - cone biopsy; Cervix - cone biopsy; Colposcopy - cone biopsy

如何执行测试

This procedure is done in the hospital or in a surgery center. 在手术过程中:

• You will be given general anesthesia (asleep and pain-free), or medicines to help you relax and feel sleepy.
• You will lie on a table and place your feet in stirrups to position your pelvis for exam. The health care provider will place an instrument (speculum) into your 阴道 to better see the 子宫颈.
• A small cone-shaped sample of tissue is removed from the 子宫颈. The procedure may be performed using a wire loop heated by electrical current (LEEP procedure), 手术刀(冷刀活检), 或者是激光束.
• The cervical canal above the cone biopsy may also be scraped to remove cells for evaluation. This is call an endocervical curettage (ECC).
• The sample is examined under a microscope for signs of cancer. This biopsy may also be a treatment if the provider removes all of the diseased tissue.

Most of the time, you will be able to go home the same day as the procedure.

如何准备考试

You may be asked to not eat or drink for 6 to 8 hours before the test.

考试的感觉如何

After the procedure, you may have some cramping or discomfort for about a week. For about 4 to 6 weeks avoid:

• Douching (douching should never be done)
• 性交
• 使用卫生棉条

For 2 to 3 weeks after the procedure, you may have discharge that is:

• 血腥的
• 重
• 黄色的

为什么要进行测试

锥活组织检查 is done to detect 子宫颈癌 or early changes that lead to cancer. A cone biopsy is done if a test called 阴道镜 cannot find the cause of an abnormal Pap smear.

锥活组织检查 may also be used to treat:

• Moderate to severe types of abnormal cell changes (called CIN II or CIN III)
• 非常早期阶段 子宫颈癌 (第0或IA1阶段)

正常的结果

A normal result means there are no precancerous or cancerous cells in the 子宫颈.

异常结果意味着什么

Most often, abnormal results mean that there are precancerous or cancerous cells in the 子宫颈. These changes are called cervical intraepithelial neoplasia (CIN). The changes are divided into 3 groups:

• CIN -轻度发育不良
• CIN II -- moderate to marked dysplasia
• CIN III -- severe dysplasia to carcinoma in situ

Abnormal results may also be due to 子宫颈癌.

风险

锥体活检的风险包括:

• 出血
• Incompetent 子宫颈 (which may lead to 早产)
• 感染
• Scarring of the 子宫颈 (which may cause painful periods, 早产, and difficulty getting pregnant)
• Damage to the bladder or rectum

锥活组织检查 may also make it hard for your provider to interpret abnormal Pap smear results in the future.

参考文献

Cohen PA, Jhingran A, Oaknin A, Denny L. 子宫颈癌. 《十大赌博平台排行榜》. 2019;393(10167):169-182. PMID: 30638582 pubmed.ncbi.nlm.国家卫生研究院.gov / 30638582 /.

Salcedo MP, Phoolcharoen N, Schmeler KM. Intraepithelial neoplasia of the lower genital tract (子宫颈, 阴道, 阴户):病因, 筛选, 诊断, 管理. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. 全面的妇科. 8日艾德. Philadelphia, PA: Elsevier; 2022:chap 29.

沃森拉. 宫颈锥形切除术. 见:福勒GC编. Pfenninger and Fowler's Procedures for 初级护理. 第四版. Philadelphia, PA: Elsevier; 2020:chap 128.