Abstract | Cilj istraživanja: Svrha ovog istraživanja bio je usporediti odabrane parametre između bolesnica sa lezijama vrata maternice liječenih LLETZ-om i konizacijom u Klinici za ženske bolesti i porode Kliničkog bolničkog centra Split.
Metode istraživanja: Ovo istraživanje je retrospektivna studija provedena u Klinici za ženske bolesti i porode u Kliničkom bolničkom centru Split u razdoblju od 1. siječnja 2014. do 1. siječnja 2019. godine gdje se analizirala povijest bolesti operiranih konizacijom i LLETZ-om, a obuhvatila je 550 bolesnica. Promatrani parametri jesu: dob, paritet, PHD bioptata prije operacije, veličina konusa, metoda (konizacija, LLETZ-om), prethodna operacija, dani hospitalizacije, dijagnoza.
Rezultati: Ispitanici liječeni konizacijsom bili su značajno stariji u odnsou na one liječene LLETZ-om (40,47 ± 10,28 vs. 36,29 ± 10,05 godina, P0.001), dok nije bilo razlike u paritetu. Nadalje ispitanici liječeni LLETZ-om imali su značajno kraće trajanje hospitalizacije (3,56 ± 1,08 vs. 1,99 ± 1,16 dana, P<0,001), manji volumen uzoraka (10,78 ± 9,86 cm3 vs. 6,57 ± 4,68 cm3, P<0,001), ali i manji udio uzoraka s čistim rubovima (329 (91,38%) 158 (83,16%) P=0,006). Nije bilo značajnih razlika u vrsti prethodne operacije. Postoje statistički značajne razlike u udjelu određenih dijagnoza citološkog nalaza preoperacijskog Papa testa LSIL 6 (1,80%); 22 (11,60%) i HSIL 322 (89,30%); 151 (79,50%) i histološkog nalaza operacijskog uzorka LSIL 21 (5,80%); 16 (8,40%) i HSIL 311 (86,40%); 151 (79,50%) između bolesnica liječenih konizacijom i LLETZ-om dok nije bilo razlika u histološkom nalazu preoperacijske biopsije. Postoje statistički značajne razlike u udjelu različitih vrsta cervikalnih intraepitelnih neoplazija prema histološkom nalazu preoperacijske biopsije CIN 112 (3,40%); 8 (4,30%); CIN 2 70 (19,30%); 58 (30,50%), CIN 3278 (77,30%); 124(65,20%) P=0,031 i histološkog nalaza operacijskog uzorka CIN 130 (8,20%), 23 (11,90%); CIN 2 31 (8,60%) 35 (18,50%); CIN 3 299 (83,10%) 132 (69,60%), P=0,005. Postoje statistički značajne razlike između metodoloških uzorkovanja citološkog nalaza preoperacijskog Papa testa, histološkog nalaza preoperacijske biopsije i histološkog nalaza operacijskog uzorka, P<0.001. Nadalje, bilo je značajnih razlika u histološkom nalazu preoperacijskih biopsija i operacijskog uzorka, P<0.001.
Zaključci: Osobe operirane konizacijom su starije od osoba operiranih LLETZ-om. Bolesnice koje su operirane LLETZ-om kraće su hospitalizirane nego operirane konizacijom. Kod operacija konizacijom veći je volumen uzorka u odnosu na operacije LLETZ-om. Čisti rubovi uzorka su kod učinjene konizacije su učestaliji u odnosu na rubove kod operacije LLETZ-om. Histološki nalaz preoperacijske biopsije i histološki nalaz operacijskog uzorka pokazuju značajno različite CIN dijagnoze. Postoje značajne razlike u dijagnozama između različitih metodoloških uzorkovanja (citološki nalaz preoperacijskog Papa testa, histološki nalaz preoperacijske biopsije i histološki nalaz operacijskog uzorka). Postoje značajne razlike u dijagnozama između histološkog nalaza preoperacijske biopsije i operacijskog uzorka. |
Abstract (english) | Aims and objectives: The purpose of this study was to compare the selected parameters between the cervical cancer patients treated with conization and LLETZ in the Clinic for Female Diseases and Births of University Hospital of Split.
Materials and Methods: This study is a retrospective study conducted at the Clinic for Female Diseases and Births of University Hospital of Split from January 1, 2014 to January 1, 2019 where patients history of illness who were operated by conization and LLETZ was analyzed and included 550 patients. The observed parameters are: age, parity, PHD biopsy before surgery, cone-shaped sample size, method (conization, LLETZ), previous operation, hospitalization, diagnosis.
Results: Patients operated conization were considerably older in relation to those treated with LLETZ (40.47 ± 10.28 vs. 36.29 ± 10.05 years, P<0.001), while there was no parity difference. Furthermore, LLETZ treated subjects had significantly shorter hospitalization time (3.56 ± 1.08 vs. 1.99 ± 1.16 days, P <0.001), lower sample volume (10783.05 ± 9866.57 vs. 6575 , 33 ± 4682.70 mm3, P <0.001), but also a smaller proportion of clean edges (329 (91.38%) 158 (83.16%) P = 0.006). There were no significant differences in the type of previous surgery. There were statistically significant differences in the share of certain diagnoses of cytological finding of preoperative Papa LSIL 6 test (1.80%); 22 (11.60%) and HSIL 322 (89.30%); 151 (79.50%) and the histological finding of the LSIL 21 (5.80%); 16 (8.40%) and HSIL 311 (86.40%); 151 (79.50%) between patients treated with conization and LLETZ until there was no difference in the histological finding of preoperative biopsies. There are statistically significant differences in the share of different types of cervical intraepithelial neoplasia by histological finding of preoperative biopsy CIN 112 (3.40%); 8 (4.30%); CIN 2 70 (19.30%); 58 (30.50%), CIN 3278 (77.30%); 124 (65.20%) P = 0.031 and the histological finding of the CIN 130 (8.20%), 23 (11.90%); CIN 2 31 (8.60%) 35 (18.50%); CIN 3 299 (83.10%) 132 (69.60%), P = 0.005. There were statistically significant differences between the methodological samples of the cytological finding of the preoperative Papa test, the histological finding of the preoperative biopsy and the histological finding of the surgical samples, P<.0.001. Furthermore, there were statistically significant differences in the histological finding of the preoperative biopsy and the operation sample, P<.0.001.
Conclusions: Patients undergoing conization are older than patients undergoing by LLETZ. Patients treated with LLETZ have spent less time in the hospital than treated with conization. If patients are operated conization, there is a greater volume of the sample compared to LLETZ operations. The clear edges of the cone-shaped sample are more frequent in conization than in the LLETZ operation. Histological findings of the preoperative biopsy and the histological finding of the surgical sample show significantly different CIN diagnosis. There are significant differences in diagnosis between different methodological samples (cytological findings of preoperative Pope test, histological findings of preoperative biopsy and histological findings of the surgical sample). There are significant differences in the diagnosis between histological findings of the preoperative biopsy and the operation sample. |