论文部分内容阅读
目的探讨宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)患者行宫颈环形电切术(loop electrical excision procedure,LEEP)治疗后复发的相关危险因素。方法回顾性分析2010年6月至2012年1月江苏盛泽医院行LEEP术治疗248例CIN患者临床资料,于术后6、12、18、24个月门诊复查阴道镜、液基薄层细胞学(thin-preparation cytologic test,TCT)与高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)负荷状态,进行单因素分析与多因素Logistic回归分析处理数据资料。结果单因素分析结果发现,术前CIN病理级别(CINⅢ)、HR-HPV持续高负荷状态、标本切缘阳性及宫颈腺体受累及与CIN患者术后复发显著相关;多因素Logistic回归分析结果表明,HR-HPV持续高负荷状态、标本切缘阳性、宫颈腺体受侵犯是CIN患者LEEP术复发的独立危险因素。结论 HR-HPV持续高负荷状态、手术标本切缘阳性及腺体受累是CIN术后复发的高危因素,对CIN患者LEEP术复发有较高临床预测价值。
Objective To investigate the risk factors of recurrence after cervical intraepithelial neoplasia (CIN) undergoing loop electrical excision procedure (LEEP). Methods The clinical data of 248 patients with CIN treated by LEEP at Shengze Hospital of Jiangsu Province from June 2010 to January 2012 were retrospectively reviewed. Colposcopy, liquid-based thin-layer cells (TCT) and high-risk human papillomavirus (HR-HPV) load status, univariate analysis and multivariate logistic regression analysis were used to analyze the data. Results The results of univariate analysis showed that preoperative CINⅢ, HR-HPV sustained high load, positive margins of the specimens and cervical gland involvement were significantly associated with postoperative recurrence in CIN patients. Multivariate Logistic regression analysis showed that , HR-HPV sustained high-load state, positive specimen margin, invasion of cervical gland is an independent risk factor for recurrent LEEP in patients with CIN. CONCLUSION: HR-HPV continues to be in a high-load state. Positive surgical margins and glandular involvement are the risk factors for recurrence of CIN. It is clinically valuable in relapse of LEEP in patients with CIN.