论文部分内容阅读
目的探讨宫颈电圈切除术(LEEP)对宫颈上皮内瘤变(CIN)的诊疗价值,观察高危型人乳头瘤病毒(HPV)感染是否消失以此评估该治疗方法对CIN治疗的有效性。方法对112例组织学证实CIN患者行宫颈电圈环行切除术,治疗后3个月随诊时再次行TCT检查及检测高危型HPV。结果CINⅠ组HPV转阴率为72.5%(29/40),病变残留(切缘阳性)率为5%(2/40);CINⅡ组HPV转阴率为37.5%(6/16),病变残留率为37%(6/16)。CINⅢ组HPV转阴率为43.7%(7/16),病变残留率为25%(4/16)。三组患者的病变残留与HPV持续阳性成正比。CINⅠ组治疗后HPV阴转率及病灶彻底切除率均高于CINⅡ、Ⅲ组,差异有统计学意义。CINⅡ组与CINⅢ差异无统计学意义。结论①高危型HPV感染率与CIN程度成正比,在CINⅡ、Ⅲ中高于CINⅠ。②LEEP不仅可以有效地治疗CINⅠ,而且可以使其伴行的HPV感染消失,③LEEP治疗CINⅡ、Ⅲ加大宫颈组织的切除范围和深度。④LEEP治疗后残留病变和HPV持续阳性密切相关。⑤TCT和HPV检测不仅可以评价宫颈疾病治疗效果而且可以作为CIN治疗后踪随访的有效手段。
Objective To evaluate the value of LEEP in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN) and evaluate the effectiveness of this treatment on CIN after observing whether high-risk human papillomavirus (HPV) infection has disappeared. Methods One hundred and twelve patients with histologically proven CIN underwent cervical ring electrosurgical resection. TCT and TCT were performed again at 3 months after treatment. Results The negative rate of HPV in CINⅠ group was 72.5% (29/40) and the rate of residual disease (positive margin) was 5% (2/40) in CINⅠ group. The negative rate of HPV in CINⅠ group was 37.5% (6/16) The rate was 37% (6/16). The negative conversion rate of HPV in CINⅢ group was 43.7% (7/16), and the residual rate of lesions was 25% (4/16). Three groups of patients with persistent lesions and positive HPV is proportional to. The negative conversion rate of HPV and complete resection of the lesions in CIN Ⅰ group were higher than those in CIN Ⅱ and Ⅲ groups, the difference was statistically significant. CIN Ⅱ group and CIN Ⅲ no significant difference. Conclusion ① The prevalence of high-risk HPV is directly proportional to the degree of CIN, higher than CINⅠ in CINⅡ and Ⅲ. ② LEEP can not only effectively treat CIN Ⅰ, and can make the accompanying HPV infection disappear, ③ LEEP treatment of CIN Ⅱ, Ⅲ to increase the scope and depth of resection of cervical tissue. ④ residual disease after LEEP treatment and persistent positive HPV are closely related. ⑤TCT and HPV testing can not only evaluate the effect of cervical disease treatment but also as an effective means of CIN follow-up.