Investigation of treatment for cervical intraepithelial neoplasia in women aged 65 years and over / 中华老年医学杂志

ABSTRACT

Objective To retrospectively analyze the treatment methods of cervical intraepithelial neoplasia (CIN) in women aged 65 years and over.Methods From July 2002 to December 2011,51 postmenopausal women aged 65 years and over with CIN were admitted to our hospital.The diagnosis and treatment were summarized and analyzed,and the CIN related literatures were discussed.Results 31 patients received colposcopy and the colposcopically directed punch biopsy.Squamocolumnar junction (SCJ) was found in 18 patients (58.1％,18/31),and not found in 13 patients (41.9％,13/31).Among the 31 patients,21 patients received conization after biopsy.9 patients were under-diagnosed by biopsy,in which 4 cases (44.4％) SCJ were found and in 5 cases (55.6％)SCJ were not found.In all patients,26 patients received conization and 20 patients received hysterectomy directly.There were 14 patients received hysterectomy after conization.Among 14 patients,the uteruses in 4 patients with conization specimen diagnosed as CIN Ⅱ-Ⅲ and negative margin were 100.0％ (4/4),and the uteruses in 3 patients with conization specimen diagnosed as CINII-Ⅲ and positive margin were 50.0％ (3/6).Conclusions For women aged 65 years and over,it is very important whether SCJ can be seen or not in colpscopy and directed punch biopsy procedure.It is better to do conization if possible.Patients with conization specimen diagnosed CINII-Ⅲ and negative margin needn't subsequent hysterectomy.Patients with positive margin but with bad general conditions or complications can continue to be monitored if they have good follow-up conditions.If patients are diagnosed as carcinoma by conization specimen,total hysterectomy or radical hysterectomy is recommended.