Diagnosis and management of 31 cases of micro-invasive carcinoma of cervix.

Objective To analyze the clinical characteristics and treatment of micro-invasive carcinoma of cervix(MIC),to investigate the value of cervical conization in the management of MIC.Methods The clinical and pathological data of 31 patients with MIC diagnosed with cervical conization in Peking Union Medical College Hospital between Nov.2005 and Oct.2007 were retrospectively analyzed.Results Of 31 patients with MIC,24 patients had cervical cytology results.Colpscopy-directed cervical biopsy was performed in all patients,which showed that 1 case(3.2%)was cervical intraepithelial neoplasia(CIN) grade 2,17 cases(54.8%) were CINⅢ,and 13 cases(41.9%) were suspected as early invasive carcinoma.Based on pathological examination of conization sample,23 patients were diagnosed as Ia1 cervical cancer(Ⅰa1 group) and 8 patients diagnosed as Ⅰa2 cervical cancer(Ⅰa2 group).In Ⅰa1 group,3 patients(13.0%) with further childbearing desire and with negative conization margin received close follow-up,1 patient(4.3%) with further childbearing desire but with positive conization margin received repeat conization,while the other 19 patients(82.6%)without further childbearing desire received hystercectomy(or plus bilateral sampingo-oophorectomy).All 8 patients in Ⅰa2 group were treated with radical hysterectomy.No disease recurrence occurred during follow-up,except one patient with uterus sparing who was found to be abnormal cervical cytology and confirmed as CINⅢ in subsequent colposcopic directed cervical biopsy.Three cases of pregnancies occurred in 4 patients whose uterus were not removed.Conclusion Colpscopy-directed cervical biopsy has important suggestive valve for patients with MIC,but the final diagnosis of MIC must only be based on conization.Post-conization treatment of MIC depends mainly on the severity of cervical lesion,while patient's desire for childbearing and conization margin status should also be taken into consideration.