Author/Editor		Lomšek, Mili; Rakar, Stelio; Kobal, Borut
Title		Zdravljenje prekanceroz materničnega vratu: analiza podatkov zdravljenih bolnic na Ginekološki kliniki v Ljubljani v obdobju 1996-2000
Translated title		Cervical intraepithelial neoplasia treatment: analysis of the data of the patients treated at Department of gynecology and obstetrics in Ljubljana during 1996-2000
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 2
Publication year		2003
Volume		str. II-147-50
Language		slo
Abstract		Background. Successful diagnosis and management of cervical intraepithelial neoplasia (CIN) prevent the occurrence of invasive cervical cancer, which is one of the important indicators of the national health care. Methods. The retrospective analysis studies patients at Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, who had in the period from January 1990 to December 2000 cervical biopsy due to CIN suspicion, based on abnormal PAP smear test and/or abnormal colposcopy. The patients, whose CIN diagnosis was confirmed with cervical biopsy sample histology, were treated by local methods (laser vaporisation, laser conization, large loop excision of the transformation zone (LLETZ), cold-knife conization), hysterectomy or just supervised with 4-6 month PAP smear and colposcopy follow-up. Our efficiency criteria were PAP smear one year after the treatment and excised tissue histology (for local excision methods and hysterectomy). We also compared the histology of the cervical biopsy sample and the excised tissue after excision methods of treatment and hysterectomy. The sources of our database were the patients' records. Results. The study analyses 800 patients. In 195 women (24%) CIN wasn't confirmed by cervical biopsy sample histology. In the remaining 605 patients (76%), we diagnosed evere dysplasia (CIN III) in 332 women (55%), moderate dysplasia (CIN II) in 153 women (25%) and light dysplasia (CIN I) in 120 women (20%). CIN was most frequently diagnosed in the age between 30 and 34. CIN III was most frequently treated with cold-knife conization and CIN II with laser vaporisation. We also treated 120 patients (66%) with CIN I, mostly with laser vaporisation. There were no substantive differences in therapeutic efficacy between the methods of treatment. (Abstract truncated at 2000 characters).
Summary		Izhodišča Uspešno odkrivanje in zdravljenje prekanceroz materničnega vratu preprečujeta nastanek invazivnega raka materničnega vratu, ki je eden od pomembnih kazalnikov kakovosti nacionalnega zdravstva. Metode. v retrospektivni analizi obravnavamo bolnice, pri katerih je bila na Ginekološki kliniki v Ljubljani, v obdobju med januarjem 1996 in decembrom 2000 narejena biopsija materničnega vratu zaradi suma na prekancerozo, postavjenega na podlagi patološkega citološkega brisa materničnega vratu po Papanikolaouu in/ali patološkega kolposkopskega izvida. Bolnice, pri katerih je bila diagnoza prekanceroze potrjena s histološkim izvidom bioptičnega materiala, so bile zdravljene z eno od lokalnih metod zdravljenja (laserska vaporizacija, laserska konizacija, ekscizija z električno zanko, klasična konizacija) s histerektomijo, ali pa so bile le nadzorovane s kontrolnimi citološkimi brisi materničnega vratu po Papanikolaouu in kolposkopskimi pregledi v 4- do 6-mesečnih presledkih. Kot merilo uspešnosti smo upoštevali kontrolni citološki bris materničnega vratu po Papanikolaouu eno leto po zdravljenju pri laserski vaporizaciji in histološki izvid ekscidiranega tkiva pri ostalih metodah zdravljenja. Analizirali smo tudi ujemanje histološkega izvida bioptičnega tkiva materničnega vratu in ekscidiranega tkiva pri lokalnih ekscizijskih metodah zdravljenja (laserska konizacija, ekscizija z električno zanko, klasična konizacija) in histerektomiji. Izhajali smo izpodatkov, zabeleženih v ambulantnih kartotekah bolnic. Rezultati. V analizo smo zajeli 800 bolnic. Napovedne diagnoze prekanceroze materničnega vratu nismo potrdili s histološkim izvidom bioptičnega materiala pri 195 bolnicah (24%). Pri 605 bolnicah s potrjeno diagnozo prekanceroze (76%) smo našli hudo stopnjo prekanceroze (CIN Ill) pri 332 bolnicah (55%), zmerno (CIN II) pri 153 bolnicah (25%) in blago stopnjo prekanceroze (CIN I) pri 120 bolnicah (20%). (Izvleček skrajšan pri 2000 znakih).
Descriptors		CERVICAL INTRAEPITHELIAL NEOPLASIA VAGINAL SMEARS CONIZATION HYSTERECTOMY LASER COAGULATION